Surge in testicular torsion in pediatric patients during the COVID-19 pandemic

https://doi.org/10.1016/j.jpedsurg.2021.07.008Get rights and content

Highlights

  • What is currently known about this topic?.

  • Testicular torsion is a pediatric surgical emergency.

  • Prompt diagnosis and treatment is imperative.

  • Patients may be reluctant to seek medical care during COVID-19.

  • What new information is contained in this article?.

  • Significant increase in testicular torsion cases during the COVID-19 pandemic compared to equivalent time periods in 2015–2019 (38 vs. 15.8, p = 0.05).

Abstract

Background

Testicular torsion is a pediatric surgical emergency, and prompt diagnosis and treatment is imperative. During the COVID-19 pandemic, pediatric patients with symptoms of testicular torsion may be reluctant to seek medical care which increases the likelihood of delayed presentation and the need for an orchiectomy. This observational study sought to determine whether there was a higher number of testicular torsion cases during COVID-19.

Methods

As the first patient with COVID-19 was admitted to our facility on March 6, 2020, we identified male children ages 1–18 years with testicular torsion between March 1-December 31, 2020 (during COVID-19) compared to the same time period between 2015 and 2019 (prior to COVID-19). All patients were evaluated at our Institution's Emergency Department by a pediatric urologist.

Results

There were 38 cases of testicular torsion between March 1-December 31, 2020 compared to 15.8 cases on average during the same 10-month period between 2015 and 2019 (a total of 79 cases). There was a statistically significant increase in testicular torsion cases during the COVID-19 pandemic compared to equivalent time periods in 2015–2019 (38 vs. 15.8, p = 0.05). Patients with testicular torsion during the COVID-19 pandemic were younger, had a longer duration of symptoms, and had a higher number of orchiectomies (although not statistically significant).

Conclusion

During the COVID-19 pandemic, an escalation in testicular torsion cases was observed. Timely assessment, diagnosis, and surgery are crucial to prevent testicular loss and potential infertility in the future. Further evaluation is needed to elucidate the surge in testicular torsion and possible mechanisms.

Keywords

Pediatric surgery
Pediatric urology
Testicular torsion
COVID-19
Orchiectomy
Abbreviations
2019-nCoV
Novel coronavirus
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
ED
Emergency Department

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