Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials.

AIM: This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated coblation versus laser (carbon dioxide and diode) tonsillectomy, with regard to various surgical and clinical outcomes. METHODS: We searched PubMed, CENTRAL, Scopus, and Web of Science for relevant from inception until March 2021. We evaluated risk of bias using the Cochrane Collaboration Tool. We summarized the outcomes as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with 95% confidence interval (CI). We conducted subgroup analysis based on the day of postoperative pain (day 1, day 7, and day 14) and type of postoperative hemorrhage (reactionary and secondary). In addition, we conducted subgroup analysis according to the type of laser. RESULTS: Five RCTs were analyzed. Three and two RCTs were evaluated as having "some concerns" and "low risk of bias", respectively. Coblation tonsillectomy correlated with lower intraoperative blood loss (MD = -5.08 ml, 95% CI [- 7.33 to - 2.84], P < 0.0001) and lower operative time (MD = - 4.50 min, 95% CI [- 6.10 to - 2.90], P < 0.0001) compared with the laser tonsillectomy. However, there was no significant difference between both groups regarding the postoperative pain score (SMD = - 0.27, 95% CI [- 0.72 to 0.17], P = 0.27) and rate of postoperative hemorrhage (RR = 0.95, 95% CI [0.27-3.40], P = 0.23). Subgroup analysis reported similar insignificant difference between both groups according to the day of postoperative pain and type of postoperative hemorrhage. CONCLUSIONS: Coblation tonsillectomy correlated with a significant reduction in intraoperative blood loss and operative time compared with the laser technique. Nevertheless, these effects do not seem clinically meaningful in surgical practice.

Evaluation of lower urinary tract symptoms among male COVID-19 patients during the second wave: An observational study.

Background: Coronavirus disease-19 (COVID-19) pandemic has affected almost all age groups globally, and lower urinary tract symptoms (LUTS) may be one of the early manifestations of COVID-19, especially in elderly patients. This study aimed at evaluating LUTS in male COVID-19 patients during the COVID-19 s wave. Methodology: A prospective observational study was conducted between March 15, 2021, and March 25, 2021, at the Prince Hamza Hospital in Amman, Jordan. Newly admitted COVID-19 confirmed male patients who were able to fill the LUTS (validated) questionnaire were included. Vitally unstable patients requiring intensive care unit admissions or medical or surgical intervention (except catheterization) for their presenting symptoms were excluded. Results: Two-hundred and four patients (mean age: 51.1 ± 17.3 years) were included; among COVID-19 symptoms, augmented urinary frequency (3.4%) was the commonest urological symptom, followed by dysuria (1.0%), and acute urinary retention (1.0%). Twenty-four patients (10.8%) had benign prostatic hyperplasia, two patients had bladder cancer, and one hadprostate cancer. Most patients exhibited mild symptoms on international prostate symptom score (IPSS) before (n = 149, 67.1%) and during (n = 157, 70.7%) COVID-19, and this difference between IPSS scores was statistically significant (P = 0.025). Both IPSS sub-scores of storage (IPSS/S) and voiding (IPSS/V) had a positive correlation with pre- and post-COVID-19 scores (IPSS/S: P < 0.001, r = 0.63; IPSS/V: P < 0.001, r = 0.76). Conclusion: This study demonstrated a strong correlation between COVID-19 and LUTS; therefore, COVID-19 infection should be investigated and excluded in any patient presenting with LUTS during the current pandemic. Further research is needed to elucidate the exact pathophysiology of this correlation.