# 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.

## Key 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.