Watson R A
Urology. 1975 Apr;5(4):439-43. doi: 10.1016/0090-4295(75)90063-1.
Torsion of the spermatic cord in the neonate should no longer be considered a clinical rarity. Effectual diagnosis is totally dependent on prompt detection of an asymptomatic, irreducible scrotal swelling that fails to transilluminate. Immediate surgical exploration is indicated. Detorsion and careful inspection for signs of circulatory return should be undertaken in every case. Frankly necrotic testes should probably be removed, but conservation of testicular tissue is otherwise strongly recommended, even in the borderline cases. After detorsion testis must be firmly fixed in proper position. Prophylactic contralateral orchiopexy appears to be advisable, unless a congenital hydrocele intervenes. Most importantly, to avert the grim prognosis this condition bears, we must continually alert our colleagues responsible for neonatal care to the possibility of torsion of the spermatic cord in the immediate postpartum examination of every newborn male infant.
新生儿精索扭转不应再被视为临床罕见病。有效的诊断完全依赖于及时发现无症状、不可复性且不透光的阴囊肿胀。应立即进行手术探查。每例病例均应进行扭转复位并仔细检查循环恢复的迹象。明显坏死的睾丸可能应予以切除，但在其他情况下，即使是临界病例，也强烈建议保留睾丸组织。扭转复位后，睾丸必须牢固固定在适当位置。除非存在先天性鞘膜积液，否则预防性对侧睾丸固定术似乎是可取的。最重要的是，为避免这种情况带来的严峻预后，我们必须不断提醒负责新生儿护理的同事，在对每例新生男婴进行产后即刻检查时，要注意精索扭转的可能性。
