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Neo-Natal Testis Torsion

By Philip E. Gleason, MD

The testicles form by the kidneys. During the last month or two of the pregnancy they work their way down along the back, through the groin and into the scrotum. Occasionally, as they migrate down into the scrotum the blood vessels to the testicle will get twisted and the testicle will be twisted or have neo-natal torsion.

This is often noted on the routine newborn physical exam. The testicle will be hard and have a blue or black discoloration, although it typically does not appear to cause any pain. This can often be evaluated with an ultrasound of the scrotum to confirm the diagnosis and plan any further treatment needed.

The treatment of neo-natal torsion is somewhat controversial. Some Pediatric Urologists observe the testicles. Others recommend removing the twisted testicle and putting stitches around the normal testicle to protect it from twisting.