Neonatal torsion is an extravaginal torsion, involving the entire spermatic cord, including the processus vaginalis (Basta et al.
Neonatal torsion is more commonly an extravaginal torsion involving the spermatic cord, testis, and tunica vaginalis versus the more common intravaginal torsion involving only the spermatic cord and testis.
In extravaginal torsion
, the spermatic cord and testis twist along with the tunica vaginalis, while in intravaginal torsion, the spermatic cord and testis twist inside the tunica vaginalis.
With extravaginal torsion
, which is more common in the neonate, the testicle, epididymis, vascular plexus, and tunica undergo torsion.
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.
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.