Clinical value of intravesical prostatic protrusion in the evaluation and management of prostatic and other lower urinary tract diseases

Abstract

Intravesical prostatic protrusion (IPP) has emerged as a new prostatic morphometric parameter of significance to aid the clinicians in various aspects of managing the patients with some diseases of the lower urinary tract and the prostate. These include but may not be limited to its role in such conditions as: bladder outlet obstruction, trial without catheter, medical treatment effect, progression of lower urinary tract symptoms related to benign prostatic hypertrophy (LUTS/BPH), risk factor for bladder stone in BPH, overactive bladder, prostate carcinoma, and early urinary continence recovery after laparoscopic radical prostatectomy. In this review, I will try to summarize the different researchers' efforts on the potential practical application of this clinical tool. Technology is ever evolving to help us in the diagnosis and management of our patients. However, we as clinicians should contemplate their cost and possible suffering for the patient by wise and judicious utilization based on our clinical experience and tools. IPP seems to be one such promising clinical tool.

Pre- and Postoperative Parameters on Magnetic Resonance Imaging Predict Continence Recovery after Laparoscopic Radical prostatectomy

“…The core condition of urinary continence is the balance of detrusor contractility and urethral pressure. Intravesical prostatic protrusion was identi ed to be associated with lower urinary tract symptoms and overactive bladder [25,26]. It is supposed that longer IPPL contributes to pathophysiological changes of bladder detrusor such as detrusor hyperactive, detrusor instability and subsequent bladder dysfunction, and then leads to a delay in continence recovery after RP.…”

“…It is supposed that longer IPPL contributes to pathophysiological changes of bladder detrusor such as detrusor hyperactive, detrusor instability and subsequent bladder dysfunction, and then leads to a delay in continence recovery after RP. Furthermore, the impact of intravesical prostatic protrusion on more surgical damage of the internal sphincter during bladder neck dissections put forward as a possible contributor [25]. However, the underlying mechanisms by which IPPL affects continence recovery after RP remains unclear.…”

Current status and progression of lower urinary tract symptoms in Chinese male patients: the protocol and rationale for a nationwide, hospital-based, prospective, multicentre study

“…The measurement of prostatic volume will be carried out via transrectal prostate ultrasound with the patient in a left decubitus position and the prostate ellipsoid formula (length×width× height× π/6) will be adopted for calculation 20. In case of a well-described median lobe, intravesical prostatic protrusion (IPP) will be measured as the distance between the tip of the prostate median lobe and bladder neck 21. The prostatic volume and IPP will be measured at baseline assessment and then yearly after oral medication treatment.…”

Impact of Preoperative Magnetic Resonance Imaging Anatomic Features on Urinary Continence Recovery after Laparoscopic Radical Prostatectomy

“…In contemporary studies, intravesical prostatic protrusion length (IPPL) has been identified to be a new prostatic morphometric parameter for predicting bladder outlet obstruction, progression of benign prostatic hypertrophy, and overactive bladder [8]. Furthermore, IPPL was proposed to be a measurable predictor of urinary continence recovery after laparoscopic RP (LRP) in recent studies [9,10].…”