Background

Transurethral resection of the prostate (TURP) remains the standard surgical treatment for benign prostatic hyperplasia (BPH), but its efficacy decreases in large prostates. Bipolar enucleation of the prostate (BipolEP) has been introduced as a modification enabling complete adenoma removal and potentially superior outcomes. This study compared the efficacy and safety of bipolar TURP (B-TURP) and BipolEP in patients with large prostate volumes (≥ 80 mL).

Patients and methods

Seventy patients with prostate volume ≥ 80 mL and bladder outlet obstruction were prospectively randomized to undergo either B-TURP (n = 37) or BipolEP (n = 33). Both procedures were performed using standardized bipolar platforms. Postoperative management followed uniform bladder irrigation and catheterization protocols. Primary outcomes were functional parameters (IPSS, Qmax, PVR), while secondary outcomes included perioperative parameters and complications. ANCOVA analysis adjusting for baseline IPSS and Qmax, and Post-hoc power analysis were performed.

Results

Both groups showed significant postoperative improvement in IPSS, Qmax, and PVR (p < 0.001). Compared with B-TURP, BipolEP achieved a greater reduction in IPSS (p = 0.04) and higher postoperative Qmax (p = 0.004). Operative time, irrigation volume, catheterization duration, and residual tissue were all significantly lower in the BipolEP group (p < 0.05). Retrograde ejaculation occurred more frequently after BipolEP (81.8% vs. 48.6%, p = 0.004), whereas other complications were comparable. ANCOVA confirmed that between-group differences in IPSS and Qmax remained significant after adjusting for baseline values.

Conclusion

In patients with large prostates, BipolEP offers superior functional outcomes and improved perioperative efficiency compared with B-TURP, though at a higher risk of retrograde ejaculation. These findings support BipolEP as a preferred surgical option for large-volume BPH.

ABSTRACT
Cattle in tropical and Mediterranean regions are susceptible to theileriosis, a serious tick-borne disease that impairs animal health and productivity and causes significant financial losses. This study aimed to determine the prevalence of Theileria spp. infection among crossbred cattle in Assiut Province, Upper Egypt, using microscopic examination and molecular PCR confirmation. A total of 200 blood samples were collected from crossbred cattle, including 84 apparently healthy animals and 116 animals presenting clinical signs suggestive of theileriosis. Microscopic examination of Giemsa-stained blood smears revealed an overall prevalence of Theileria spp. infection of 38.5% (77/200). Infected animals were more frequently observed among the clinically suspected group, with a significantly higher prevalence of 54.31%, compared to the apparently healthy group. Analysis of epidemiological factors revealed that age-related analysis showed that cattle older than one year had a higher infection rate (47.5%), and females exhibited greater prevalence than males. Seasonal variation was evident; infection rates peaked during the hot season at 44.23% and declined to 32.29% in the cold season, although these factors (age, sex and season) were not statistically significant (P> 0.05). Tick infestation was significantly associated with Theileria spp. infection (P< 0.05), indicating its crucial role in disease transmission. Molecular confirmation of selected heavily infected samples was performed using PCR targeting the Tams1 gene, successfully amplifying a 721 bp fragment, confirming the presence of T. annulata. This study concludes a moderate prevalence of Theileria spp. infection in crossbred cattle in Assiut Province, highlighting the critical need for integrated tick management and diagnostic surveillance to mitigate health and economic impacts.
Key words: Cattle, Epidemiology, Molecular identification, PCR, Theileria annulata, Ticks, Assiut, Egypt.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune mediated tissue damage affecting a wide range of organs. The pathogenesis of SLE is complex. Infectious agents, including viruses, can act as environmental triggers, inducing or promoting onset and exacerbations of autoimmune disease in genetically predisposed individuals. Viral infections may be involved in the pathogenesis of SLE. To date, there is no published data about role of herpes simplex virus (HSV) in pathogenesis of SLE in Egyptian population. This study was designed to investigate a possible role of HSV in pathogenesis of SLE and its relation to disease activity. This study included 90 SLE female patients and 83 apparently healthy age-matched female subjects. SLE disease activity was assessed using SLEDAI-2K score. Qualitative assessment of anti-HSV antibodies (HSV1/2 IgM and IgG) was performed using ELISA kits. There was no statistically significant difference in frequency of HSV1/2 IgG positive test between SLE patients (97.6%) and control subjects (94.4%). There was a statistically significant increase in frequency of HSV1/2 IgM positive test in SLE patients compared to control subjects (P< 0.001). There was no difference in the frequency of HSV1/2 IgM and HSV1/2 IgG positive test results between SLE patients with higher disease activity score (60% and 95.6%, respectively) and those with lower disease activity score (60% and 93.3%, respectively). High prevalence of HSV1/2 IgG antibodies was observed among Egyptians. The lack of significant difference in frequency of HSV1/2 IgG between SLE patients and control