A Review of Intravesical Prostatic Protrusion in the Evaluation and Treatment of Benign Prostatic Enlargement

Abstract

The evaluation of severity of symptoms, tracking complications, choosing effective and efficient approach to treatment, and prognosis is important in benign prostatic enlargement (BPE) patients. Measurement of intravesical prostatic protrusion (IPP) is an easy, affordable and non-invasive marker for benign prostatic obstruction with a high diagnostic value. This study aims to undertake a descriptive review of current literature for the role of IPP in the evaluation and treatment of patients with BPE. Relevant articles written in English language were retrieved from PubMed and Google Scholar. Keywords used for searching articles included intravesical prostatic Protrusion and Benign Prostatic Enlargement/ hyperplasia/ Obstruction; evaluation; and treatment. Papers published between January 1990 and October 2020 were extracted and evaluated. The analyzed studies showed that IPP can be assessed by various modalities and is important in the evaluation of symptom severity, tracking progression and complications of disease, choosing treatment option and prognostication. It is important that IPP be always assessed at the point of initial evaluation of BPE patients.

Ultrasonographic Intravesical Prostatic Protrusion in Men with Benign Prostatic Hyperplasia in Southwest Nigeria

“…Multiple studies have shown that IPP, taken together with transabdominal total prostate volume (TPVA), correlates well with benign prostatic obstruction and the progression of the disease. [ 1 2 25 26 27 ]…”

Evaluation of the Accuracy of the Use of Intravesical Prostatic Protrusion Degree as the Predictor of Benign Prostatic Hyperplasia Management

“…Measuring the size of the prostate can not determine the severity of BPH symptoms. 3 It may depend on the site and shape of prostate. 4 Median lobe arises from periurethral zone at the bladder neck may trigger a ball-valve type obstruction which may cause more obstruction than compression which is caused by lateral lobe enlargement sited deep in the transitional zone.…”

“…1 Patients with significant IPP during their initial assessment encounter an elevated risk of BPHrelated surgeries. 29 Therefore, it would be better to identify patients before the treatment whether they will or not respond to medical treatment. 28 As α-receptors are mostly present inferior to the bladder neck (distal to the area of the protrusion), 2 it may not be effective for treating IPP with alphaadrenoceptor antagonists, due to its configuration that protrudes into the bladder above the bladder neck.…”

“…2 The histopathology term "BPH" is commonly used to describe benign prostatic enlargement (BPE) in daily practice. 3 BPH is characterized by its impact on specific zones of the prostate, primarily the transitional and periurethral regions. Unlike diffuse hyperplasia affecting all zones uniformly, BPH manifests as nodular adenomatous hyperplasia, leading to distinct nodules or often multiple nodules clustered together to form adenomata.…”