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    Korean J Urol. 2008 Feb;49(2):145-149. Korean.
    Published online Feb 29, 2008.
    https://doi.org/10.4111/kju.2008.49.2.145
    Copyright © 2008 The Korean Urological Association
    Original Article

    The Correlation of Intravesical Prostatic Protrusion with Storage Symptoms, as Measured by Transrectal Ultrasound

    Jun Min Lee, Hong Chung, Tong-Wook Kim, Hong Sup Kim, Joon Ho Wang,1 and Sang-Kuk Yang
      • Department of Urology, Chungju Hospital, College of Medicine, Konkuk University, Chungju, Korea.
      • 1Department of Internal Medicine, Chungju Hospital, College of Medicine, Konkuk University, Chungju, Korea.
    Received October 05, 2007; Accepted December 07, 2007.

    Abstract

    Purpose

    Intravesical prostatic protrusion (IPP) is a morphological change that's due to excessive growth of the median and lateral lobes of the prostate into the bladder. Few studies have been performed regarding the correlation between IPP and the voiding/storage symptoms. The aim of this study is to identify the clinical significance of IPP by defining its relationship with the prostate volume (PV), the International Prostate Symptom Score (IPSS), the uroflowmetry results and the medication response.

    Materials and Methods

    We performed a retrospective study of 95 male patients who were examined between August 2006 and July 2007. The patients were evaluated with the IPSS/quality of life (QoL) test, uroflowmetry (Urodyn-1000™; Medtronic), the post void residual urine (PVR), and IPP and PV by transrectal ultrasound (TRUS) (PROSOUND SSD-3500™; ALOKA). The IPP was compared with the total IPSS, the voiding and storage symptom score, uroflowmetry parameters and the flow patterns (normal, obstructive, detrusor impairment, Valsalva). The patients were classified into two groups (the IPP and non-IPP groups) based on the presence of IPP as identified by TRUS.

    Results

    The PV and IPP showed a significant correlation (r=0.627, p< 0.001). There was no correlation between IPP and total IPSS (p=0.444); however, the storage symptom score was significantly increased in proportion to IPP (p=0.030). With an IPP increase, the Qmax was decreased (r=-0.319, p<0.001) and the PVR was increased (r=0.388, p=0.002). The IPP group showed a lower decrease of the QoL score after 8 weeks of medication, as compared to the non-IPP group (p=0.034).

    Conclusions

    The IPP showed significant correlation with the storage symptoms, but not with the total IPSS. Theoretically, IPP is a unique anatomical configuration of the prostate, and it may worsen the prominent storage symptoms that are the result of irritation of the bladder neck and trigone. IPP should be checked carefully during TRUS as IPP could potentially be a useful marker for the assessment and management of lower urinary tract symptoms.

    Keywords
    Benign prostatic hyperplasia; Bladder outlet obstruction; Ultrasound

    Figures

    Fig. 1
    Comparison of the International Prostate Symptom Score (IPSS) and the quality of life (QoL) according to the presence of intravesical prostatic protrusion at the initial visit (A), Comparison of the change of IPSS and the QoL according to the presence of intravesical prostatic protrusion after 8 weeks of medication (B), *p<0.05.

    Tables

    Table 1
    Correlation analysis between intravesical prostatic protrusion and the prostate volume/International Prostate Symptom Score/uroflowmetry parameters

    Table 2
    Comparison of occurrence of transurethral resection of the prostate and acute urinary retention during 8 weeks of medication, according to the presence of intravesical prostatic protrusion

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    MeSH Terms
    Humans
    Indoles
    Lower Urinary Tract Symptoms
    Male
    Neck
    Prostate
    Prostatic Hyperplasia
    Retrospective Studies
    Urinary Bladder
    Urinary Bladder Neck Obstruction
    Metrics
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