Acute Scrotum during the First Year of Life
The aims were to characterize spermatic cord torsion (SCT), to compare it with other causes of acute scrotum during the first year of life and to describe the distinctive features of each causative group.
Material and Methods:
Ninety-one consecutive neonates (44) and infants (47) were operated on for acute scrotum and the definitive diagnoses for the testicles thus confirmed. The duration of the symptoms and the physical findings were recorded. The histopathology of the removed testicles was studied and bacterial cultures were obtained from patients with epididymitis (ED).
Thirty-five boys (39%) had SCT, and incarcerated inguinal hernia (IH) and epididymitis were found in 22 (24%) and 21 (23%) cases, respectively. Torsion of the testicular appendage (TAT) was only seen once. A dark, hard testicle was observed in 91% of the SCT patients, but erythema and tenderness were infrequent. 30 out of 39 (77%) patients had SCT during the neonatal period, including 15 cases in which torsion had occurred prenatally. Only four testicles (11.4%) with SCT were salvaged.
The cause of acute scrotum during the first month of life was mostly SCT, while ED was seen more frequently between the ages of 3 and 6 months. A dark, hard testicle was a common finding in the SCT patients, while swelling and erythema were typical of ED. Neonatal SCT has a poor prognosis.