The case report by R. Negrine and colleagues(1) is of considerable interest. However, testicular trauma following breech delivery is not extremely rare as they suggest. In 1975 I reported 11 cases of scrotal bruising and significant testicular enlargement among 114 consecutively breech-born male infants over a two year period(2). Those affected tended to be large, first-born, singleton and term or post-term infants. One infant with particularly severe damage was found to have soft and hypoplastic testicles at the age of 10 years. It is therefore not improbable that the damage at birth may be another cause of the vanishing testicle and for sterility or gonadal dysfunction. It would be of interest to study the prior incidence of breech delivery in a large series of sterile adult males.

Correspondence to: Professor Peter M. Dunn University of Bristol, Southmead Hospital, Bristol, BS10 5NB p.m.dunn@bristol.ac.uk

References

1. Negrine, R., Easter, W., Fraser, I. and Ellis, S. Neonatal testicular trauma: scrotal rupture. Arch. Dis. Child. Fetal Neonatal Ed., 2010; 95, F.193.

2. Dunn, P.M. Testicular birth trauma. Arch. Dis. Child., 1975; 50, 743.

Conflict of Interest:

None declared