To pex or not to pex

There is little agreement as to the performance of an exploration and orchiopexy on the asymptomatic side when the neonate is found to have unilateral extravaginal torsion of the testis. If extravaginal torsion does not present bilaterally, many surgeons feel that the uninvolved testis is not at risk. Extravaginal torsion of the testis, fortunately, is a rare problem. Armed with the knowledge of this case report and one previous case report, however, it is clear that extravaginal torsion can present as separate and asynchronous events. Knowledge of this fact should stimulate surgeons to explore and pex the contralateral side upon finding extravaginal torsion of the testis.