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Neonatal Testicular Torsion is a rare but serious condition in which a newborn baby’s testicle twists around the spermatic cord. This twist blocks blood supply to the testicle, leading to swelling, pain, and risk of permanent damage if not treated quickly.
It can occur before birth (in-utero torsion) or soon after birth.
Testicular torsion happens when the tissues supporting the testicle aren’t fully developed or are too loose. Because of this, the testicle rotates and cuts off blood flow.
In newborns, this is usually extravaginal torsion, meaning the entire testicle, cord, and surrounding tissues twist as a unit.
While the exact cause is not always known, common factors include:
Loose or underdeveloped connective tissue around the testicle
Abnormal fetal positioning inside the womb
Difficult or prolonged labor
Low birth weight or prematurity
Reduced attachment of the testicle to the scrotum
Trauma (rare)
Most cases occur before birth, meaning symptoms may be present immediately after delivery.
Unlike older children, a newborn cannot express pain. Parents and doctors must look for physical signs:
One side of the scrotum appears larger, firm, or hard
The scrotal skin may appear red, dark, or purplish
General discomfort but no specific cry for scrotal pain
Gentle stroking of inner thigh normally lifts the testicle — may be absent
Swelling persists and may worsen

Doctors diagnose testicular torsion through:
Physical examination
Scrotal ultrasound with Doppler
(checks the blood flow to the testicle)
Urgent specialist evaluation (pediatric surgeon/urologist)
YES. Testicular torsion is a surgical emergency.
Immediate medical attention is required.
However, in newborns, because torsion often happens before birth, blood flow may already be severely compromised. Even then, prompt evaluation is essential to save the testicle or prevent further complications.
If detected early, doctors may try to untwist the testicle and restore blood supply.
If the testicle is already non-viable due to long-term loss of blood flow.
The healthy testicle is usually stitched in place (orchiopexy) to prevent future torsion.
If torsion happens before birth, saving the testicle is challenging because damage occurs within hours.
If torsion happens after birth and is recognized early, outcomes can be good.
The baby can live a normal life with one healthy testicle — normal fertility and hormone levels are usually maintained.
Unfortunately, torsion cannot be prevented in most newborns because it occurs suddenly and without warning. Early detection and urgent care offer the best chance for recovery.
Seek urgent medical attention if you observe:
Swelling or hardness in one side of your newborn’s scrotum
Sudden change in color (red, purple, blue)
Baby crying inconsolably without obvious reason
A noticeable difference in the size or position of testicles
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