| Summary: | Introduction We report a case of bilateral neonatal testicular torsion, with an extravaginal and a contralateral intravaginal testicular torsion. Case presentation A 5‐day‐old boy with bilateral scrotal swelling and palpable induration was diagnosed with bilateral neonatal testicular torsion by color Doppler ultrasonography. The right testis was black with 360‐degree extravaginal torsion of the spermatic cord, and the left testis was brown with 90‐degree intravaginal torsion. We repaired the torsion and incised the tunica albuginea to reduce intratesticular pressure. The left testis became pink in color, but the right testis remained unchanged. Based on the pathological findings of the intraoperative biopsy of tissue specimens from both testes, we performed a right orchiectomy and preserved the left testis. Conclusions Our experience suggests that testicular color improvement after fasciotomy and pathological findings of intraoperative testicular biopsy may indicate testicular preservation.
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