Has the Number of Pediatric Testicular Torsion Cases Abated After the Height of the COVID-19 Pandemic?

TL;DR

This study found that the number of pediatric testicular torsion cases increased during the height of the COVID-19 pandemic and then decreased afterward.

Contribution

The study provides new insights into how the pandemic affected the incidence and treatment of pediatric testicular torsion.

Findings

The number of pediatric testicular torsion cases significantly increased during the height of the pandemic.

The shortest door-to-detorsion time occurred during the pandemic period.

The number of cases decreased after the peak of the pandemic.

Abstract

Background: Starting in March 2020, the COVID-19 pandemic represented an international public health emergency which greatly impacted healthcare delivery.

Materials and methods: This retrospective analysis of pediatric testicular torsion (TT) over a 10-year period (January 1, 2015- December 31, 2024) was performed at a pediatric children's hospital in a metropolitan community. We divided our cohort into patients who were evaluated prior to COVID-19 (January 1, 2015-February 29, 2020), during COVID-19 (March 1, 2020-April 30, 2023), and after COVID-19 (March 1, 2023-December 31, 2024). We hypothesized whether the TT incidence and orchiectomy rates differed across these three time periods.

Results: A total of 286 pediatric patients underwent surgery for TT: 101 (35%) before the start of COVID-19, 129 (45%) during COVID-19, and 56 (20%) after the peak of the COVID-19 pandemic. The mean monthly case volume significantly increased from the pre-COVID-19 period (2.06) to during-COVID-19 (3.69) and post-COVID-19 (2.95) periods (p<0.0001). The median door-to-detorsion time (DTD) was significantly different across these periods, with the shortest DTD occurring during the COVID-19 period (p=0.011). The type of surgery (orchiectomy vs. orchiopexy) and symptom duration were not statistically different between the three time periods.

Conclusions: The number of patients with TT significantly increased during the height of the COVID-19 pandemic, with a subsequent reduction. Our study indicates that pediatric patients and their families realized the importance of seeking prompt medical attention for TT despite the ongoing havoc incurred by the COVID-19 pandemic.

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