Clinical Value of Intra-Vesical Prostatic Protrusion in the Evaluation and Management of Prostate

Abstract

This was a descriptive cross-sectional study, which was conducted in Khartoum state, Sudan, in different hospitals and medical centers from November 2019 to Jan 2022. The objective was to determine the Clinical value of intra-vesical prostatic protrusion in the evaluation and management of the prostate. A total of 313 males (aged 45 years and above) who presented with lower urinary tract symptoms were recruited. The prostatic volume and the degree of intra-vesical prostatic protrusion were measured by trans-abdominal ultrasonography in the sagittal planes. The IPP is graded as Grade 1 (5 mm or less), Grade 2 (more than 5 mm to 10 mm), and Grade 3 (more than 10 mm). The study showed that the distribution of urinary tract complications is slightly rare, as the normal cases were the commonest (32.3%), while cystitis is the commonest UT abnormality in (28.1%), followed by renal cyst noticed (10.5%). There was a fair positive correlation between the prostatic volume and IPP (Spearman, rs = 0514, P <0.001). Also, a small prostate with normal volume can have an IPP Grade I which is abnormal. On the other hand, IPP for the prediction of surgical treatment was 28.799±7.06mm (95% CI: -21.577- -19.063), while PV for the prediction of surgical treatment was 99.695± 25.9 ml (95% CI: -48.898- -35.69). The narrow range of IPP makes it a stronger predictor for medical management. Patients with IPP> 21.7 mm should be counseled regarding the high chance of the need for surgical treatment. However, Intra-vesical Prostatic Protrusion is a better predictor of a benign prostatic obstruction than prostatic volume.