Intravesical prostatic protrusion

Last revised by Henry Knipe on 27 Mar 2021

Intravesical prostatic protrusion is an anatomical feature that may be present in some patients with benign prostatic hyperplasia (BPH) being characterized by the enlargement of the prostate towards the floor of the bladder 1,2.

Intravesical prostatic protrusion is correlated with difficulty in urination and worsening of other symptoms of patients with prostatic hyperplasia, especially symptoms related to bladder outlet obstruction.

 The measurement of the intravesical prostatic protrusion can be performed on transrectal or transabdominal ultrasound. The distance from the tip of the protruding prostate to the base of the bladder intravesical prostatic protrusion measurement. 

IPP can be quantified into three grades:

  • grade 1: ≤5 mm
  • grade 2: 5.1-10 mm
  • grade 3: >10 mm

Despite its predictive value of clinical progression in patients with BPH and its better correlation with the bladder outlet obstruction index, when compared with prostate volume or PSA, intravesical prostatic protrusion grade should not replace the current parameters for clinical evaluation of BPH, such as urofluxometry, IPSS symptom score, residual bladder volume (post-voiding) and prostate volume.

The phenomenon of IPP was first recognized in the early 20th century by Randall 3.

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.