In the neonatal and pediatric population, there can be many physiologic problems with the male genitourinary system. what is the most common acute scrotal disorder in the pediatric population

The most common acute disorder is Testicular torsion it is a twisting of the spermatic cord that suspends the testis. Extravaginal torsion, which occurs almost exclusively in neonates, is the less common form. It occurs when the testicle and the fascial tunicae that surround it rotate around the spermatic cord at a level well above the tunica vaginalis. The torsion probably occurs during fetal or neonatal descent of the testes before the tunica adheres to the scrotal wall. Intravaginal torsion is considerably more common than extravaginal torsion. It occurs when the testis rotates on the long axis in the tunica vaginalis. In most cases, congenital abnormalities of the tunica vaginalis or spermatic cord exist. The tunica vaginalis normally surrounds the testes and epididymis, allowing the testicle to rotate freely in the tunica. Patients usually present in severe distress within hours of onset and often have nausea, vomiting, and tachycardia. The affected testis is large and tender, with pain radiating to the inguinal area.

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