ABSTRACT
Neonatal torsion accounts for up to 15% of cases of pediatric torsion. Due to reports of synchronous and asynchronous contralateral torsion and possible evidence of salvage of the postnatal testis, it is the author's view and recommendation that urgent exploration and contralateral fixation occurs. Elevated salivary amylase can be confirmatory for parotid involvement and real-time polymerase chain reaction is available in some centers. In most cases the diagnosis of the acute testicular torsion can be made clinically. The testis can be delivered from the scrotum through an incision over the longitudinal axis or obliquely in the line of the rugae or through the midline raphe. The untwisted testis should be wrapped in moist warm swabs and its color observed intermittently. The tunica albuginea can be incised to assess viability and it can relieve the pressure within the tubules. Patients with true torsion should be followed up to monitor testicular size and ensure growth.
