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Coskun Ümit: Prenatal Diagnosis of Testicular Torsion at 32 Weeks

Coskun Ümit/Instagram

Jun 27, 2026, 14:02

Coskun Ümit: Prenatal Diagnosis of Testicular Torsion at 32 Weeks

Coskun Ümit, Medical Doctor at Ankara Ataturk Sanatoryum, shared a post on LinkedIn:

“Rare Post Alert: Prenatal diagnosis of testicular torsion at 32 weeks.

This fetus was first evaluated at 32 weeks because of an abnormal appearance of the right hemiscrotum.

During the first 10 seconds of the video, the normal testicular architecture is replaced by a heterogeneous cystic lesion, raising suspicion for prenatal testicular torsion.

Six weeks later, at 38 weeks, follow-up ultrasound demonstrates the natural evolution of the process. The lesion has become smaller, irregular, hyperechogenic, and partially calcified, consistent with testicular infarction followed by atrophy (second part of the video).

Perinatal testicular torsion is a rare condition, with an estimated incidence of approximately 6 per 100,000 live births. Most cases occur during the third trimester and are believed to result from extravaginal torsion. Because the ischemic event usually precedes delivery by days or even weeks, salvage of the affected testis is rarely possible. Nevertheless, an antenatal diagnosis remains valuable, allowing appropriate parental counseling, postnatal pediatric urology assessment, and careful evaluation of the contralateral testis.

Although this case was diagnosed using gray-scale ultrasound alone, targeted color or power Doppler assessment of the fetal scrotum, when technically feasible, may provide additional support by demonstrating absent or markedly reduced intratesticular perfusion. However, Doppler should always be interpreted together with gray-scale findings, as progressive changes in echogenicity, internal architecture, contour, volume loss, and eventual calcification often provide the strongest diagnostic clues.

Take-home messages:

The fetal penis and testes should be evaluated not only to determine fetal sex, but also to identify pathology.
A third-trimester ultrasound is far more than a fetal growth examination. Many clinically significant abnormalities either develop late in pregnancy or become apparent only during the third trimester. Therefore, every anatomical survey should remain comprehensive until delivery—including careful evaluation of the fetal external genitalia.

Thanks to Dr. Elnara Sardarova (Azerbaijan) for sharing this fascinating case.”

Proceed to the video attached to the post.

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