Clinical Outcomes of Intravesical Prostatic Protrusion in Patients With Benign Prostatic Hyperplasia

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Benign prostatic hyperplasia (BPH) involves prostate enlargement, impacting urinary outflow.
• Intravesical prostatic protrusion (IPP) describes prostate tissue extending into the bladder.
• IPP can cause symptoms like incomplete voiding and weak urine stream.

Purpose of the Study:

• To investigate the association between different grades of intravesical prostatic protrusion (IPP) and clinical urological outcomes in BPH patients.
• To refine risk stratification and enhance treatment approaches for BPH by understanding IPP's impact.
• To explore the correlation between IPP severity and complications such as UTIs and acute urinary retention.

Main Methods:

• Retrospective review of 184 BPH patients undergoing transabdominal prostate ultrasound between June 2021 and December 2022.
• Assessment of IPP grade, prostate volume, bladder stones, bladder diverticulum, and post-void volume from ultrasound images.
• Multivariate logistic regression analysis to determine the odds ratios (OR) of urological outcomes associated with increasing IPP grade, controlling for age and prostate volume.

Main Results:

• IPP was graded: Grade I (28.8%), Grade II (39.1%), Grade III (22.8%), and Grade IV (9.2%).
• Bladder stones were present in 6.5% and bladder diverticulum in 9.2% of patients.
• Higher IPP grades significantly correlated with increased risk of UTIs (OR=6.8 for Grade IV), acute urinary retention (OR=7.2 for Grade IV), and surgical intervention (OR=6.4 for Grade IV).

Conclusions:

• Elevated grades of intravesical prostatic protrusion are strongly linked to adverse urological outcomes and increased patient morbidity in BPH.
• IPP grading should be integrated into routine prostate ultrasound imaging for improved BPH patient management.
• Further research into the clinical effects of IPP is recommended to optimize patient care strategies.