Testicular torsion presents in a bimodal age presentation, with extravaginal torsion
occurring in the perinatal period and intravaginal torsion peaking in puberty, although the latter can be seen at any age.
With extravaginal torsion
, which is more common in the neonate, the testicle, epididymis, vascular plexus, and tunica undergo torsion.
occurs in utero or perinatally before the testis is fixed, so the torsion occurs proximal to attachment of the tunica vaginalis, in the inguinal canal or just below it.