Skip to main content
Article
A multicenter study of acute testicular torsion in the time of COVID-19
Journal of Pediatric Urology
  • Sarah A. Holzman, University of California, Irvine
  • Jennifer J. Ahn, Seattle Children's
  • Zoe Baker, Children's Hospital Los Angeles
  • Kai wen Chuang, University of California, Irvine
  • Hillary L. Copp, University of California, San Francisco
  • Jacob Davidson, Western University
  • Carol A. Davis-Dao, University of California, Irvine
  • Emily Ewing, Western University
  • Joan Ko, Seattle Children's
  • Victoria Lee, University of California, Los Angeles
  • Amanda Macaraeg, University of California, Irvine
  • Lauren Nicassio, Seattle Children's
  • Michael Sadighian, University of California, San Francisco
  • Heidi A. Stephany, University of California, Irvine
  • Renea Sturm, University of California, Los Angeles
  • Kelly Swords, Department of Urology
  • Peter Wang, Western University
  • Elias J. Wehbi, University of California, Irvine
  • Antoine E. Khoury, University of California, Irvine
Document Type
Article
Publication Date
8-1-2021
URL with Digital Object Identifier
10.1016/j.jpurol.2021.03.013
Abstract

Background: Testicular torsion is a surgical emergency, and time to detorsion is imperative for testicular salvage. During the COVID-19 pandemic, patients may delay emergency care due to stay-at-home orders and concern of COVID-19 exposure. Objective: To assess whether emergency presentation for testicular torsion was delayed during the COVID-19 pandemic, and whether the rate of orchiectomy increased compared to a retrospective period. Study design: Patients were prospectively enrolled in a multicenter study from seven institutions in the United States and Canada. Inclusion criteria were patients two months to 18 years of age with acute testicular torsion from March through July 2020. The retrospective group included patients from January 2019 through February 2020. Statistical analysis was performed using Kruskal–Wallis tests, Chi-square tests, and logistic regression. Results: A total of 221 patients were included: 84 patients in the COVID-19 cohort and 137 in the retrospective cohort. Median times from symptom onset to emergency department presentation during COVID-19 compared to the retrospective period were 17.9 h (IQR 5.5–48.0) and 7.5 h (IQR 4.0–28.0) respectively (p = 0.04). In the COVID-19 cohort, 42% of patients underwent orchiectomy compared to 29% of pre-pandemic controls (p = 0.06). During COVID-19, 46% of patients endorsed delay in presentation compared to 33% in the retrospective group (p = 0.04). Discussion: We found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a higher proportion of patients reported delaying care. Strengths of the study include the number of included patients and the multicenter prospective design during the pandemic. Limitations include a retrospective pre-pandemic comparison group. Conclusions: In a large multicenter study we found a significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a significantly higher proportion of patients reported delaying care. Based on the findings of this study, more patient education is needed on the management of testicular torsion during a pandemic.

Citation Information
Sarah A. Holzman, Jennifer J. Ahn, Zoe Baker, Kai wen Chuang, et al.. "A multicenter study of acute testicular torsion in the time of COVID-19" Journal of Pediatric Urology Vol. 17 Iss. 4 (2021) p. 478.e1 - 478.e6
Available at: http://works.bepress.com/peter-wang/6/