Beatriz Parreira Andrade, Ana Feio, Rúben Lamas Pinheiro, Peter Etlinger and Filipa Almeida
Neonatal testicular torsion is a diagnostic and therapeutic challenge in the first 30 days of life. Prompt diagnosis is critical but often yields a low salvage rate of around 5%. This case report discusses a full-term neonate, born via cesarean section, presenting with testicular asymmetry and a discolored hemiscrotum on the first day of life. Physical examination and Doppler ultrasound confirmed left testicular torsion. Despite early diagnosis, conservative management was chosen after thorough discussion with the parents, emphasizing regular monitoring over immediate surgical intervention due to anesthesia risks and unclear benefits of early orchiectomy. At three-month follow-up, the affected testicle had atrophied, while the right testicle remained viable. This case underscores the necessity of individualized therapeutic approaches, balancing the risks of early surgery against potential long-term fertility impacts. The successful conservative management and active parental involvement highlight the importance of a comprehensive diagnostic process and interdisciplinary collaboration in managing neonatal testicular torsion.
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