Intravesical prostatic protrusion volume: effect on lower urinary tract symptoms and urinary flow in patients with...

We aimed to evaluate the effect of intravesical prostatic protrusion (IPP) in patients with benign prostatic enlargement (BPE), using three-dimensional assessment.

Men presenting with lower urinary tract symptoms (LUTS) to the urology clinic of a state hospital between March 2023 and July 2025 were evaluated. Treatment-naïve 369 BPE patients aged 50-80 years were included in the study. Prostate volume (PV), IPP length, IPP transverse diameter, IPP antero-posterior diameter, and IPP volume were measured using transabdominal ultrasonography by a single radiologist. IPP volume was calculated using the following formula: length × transverse diameter × antero-posterior diameter × 0.52.

The International Prostate Symptom Score (p = 0.014) and IPP volume (p = 0.018) were identified as two independent predictors of low Qmax in patients with BPE. Subsequently, receiver operating characteristic curve analysis was performed for IPP volume. The optimal cut-off value was 3.65 mL, with an area under the curve of 0.823. At this cut-off value, sensitivity was 80% and specificity was 79%. In the multivariate correlation analysis, only IPP volume demonstrated an independent correlation with post-void residual volume (B = 0.211, p = 0.030). In the same analysis, parameters independently correlated with the International Prostate Symptom Score included IPP length (B = 0.219, p = 0.002), IPP antero-posterior diameter (B = 0.391, p = 0.009), and IPP volume (B = 0.188, p = 0.001).

In addition to IPP length, a three-dimensional assessment of the intravesical prostate-incorporating its transverse and antero-posterior diameters-may be a more objective parameter for LUTS.