Incidence and predictive factors of isolated neonatal penile glanular torsion

Abstract

Purpose: To determine the incidence of isolated neonatal penile glanular torsion, describe the basic characteristics, and explore the relationship between foreskin and glans torsion.

Methodology: A prospective survey was conducted of all male newborns admitted to nursery after delivery, or neonates less than 3 months presenting for circumcision. Cases with associated genital malformations were excluded.

Results: The incidence of isolated neonatal penile torsion was 27% (95% CI: 22.2%-31.84%), to the left in 99% of cases. In 3.5% of cases, the penis had an angle <10 degrees, and 9.5% >20 degrees. Using Spearman's correlational coefficient, deviation of penile raphe from the midline at the foreskin tip had a better correlation with glans torsion than deviation of raphe at the coronal sulcus (0.727 vs 0.570; both significant at p<0.01).

Conclusion: Isolated neonatal penile torsion is more common than reported. The median raphe of the penis may be normal and mask unexpected glans torsion. Median raphe torsion at foreskin tip can be used as a predictor for glans torsion. Clinical significance and relation to adult penile torsion are beyond the scope of the study.