• Zenon Pogorelić, Karla Milanović, Ana Bosak Veršić, Miram Pasini, Dalibor Divković, Oliver Pavlović, Josip Lučev, and Vanja Žufić.
• Department of Pediatric Surgery, University Hospital of Split, Spinčićeva 1, Split, Croatia; University of Split, School of Medicine, Šoltanska 2, Split, Croatia. Electronic address: zpogorelic@gmail.com.
• J Pediatr Urol. 2021 Aug 1; 17 (4): 479.e1-479.e6.

IntroductionTesticular torsion is a real emergency condition which requires prompt diagnosis and surgical management to prevent testicular loss. During the coronavirus (COVID-19) pandemic, an increased avoidance of the emergency departments for non-COVID-19 illnesses has been reported in the medical literature.ObjectiveThe aim of this study was to investigate whether the COVID-19 pandemic caused increased number of orchiectomies in pediatric patients presenting with acute testicular torsion compared to pre-COVID-19 period.Study DesignA total number of 119 pediatric patients who underwent surgery for acute testicular torsion from January 2019 to December 2020 were enrolled in retrospective multi-center study from six institutions in Croatia. The patients were divided in two groups. The first group (pre-COVID-19) consisted of the patients who underwent surgery before COVID-19 pandemic (n = 68), while the second group (COVID-19) consisted of the patients who underwent surgery during the COVID-19 pandemic (n = 51). Main outcomes of the study were orchiectomy rates and time from onset of the symptoms to emergency department presentation.ResultsDuring the COVID-19 pandemic period 43.1% (22/51) of the patients underwent orchiectomy while orchiectomy was performed in 16.2% (11/68) of the patients from the pre-COVID group (p = 0.001). Median time from onset of the symptoms to emergency department presentation during COVID-19 pandemic and pre-COVID-19 periods was 14h (IQR 5, 48) and 6h (IQR 3, 22) (p = 0.007), respectively. A higher proportion of patients waited over 24 h to present to emergency department during the COVID-19 pandemic compared to the pre-COVID-19 period (47% vs 8.8%, p = 0.007).ConclusionDuring COVID-19 pandemic a significantly higher rates of orchiectomies and increase in delayed presentations for testicular torsion was found. More patient education during pandemic in regards to management of emergency conditions such as testicular torsion is required.Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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