Jason Gandhi1,2, Steven J Weissbart3, Albert N Kim3, Gunjan Joshi4, Steven A Kaplan5,6, Sardar Ali Khan1,3. 1. Department of Physiology and Biophysics, Stony Brook University Medicine, Stony Brook, Southampton, New York. 2. Department of Medical Student Research Institute, St. George's University School of Medicine, St. George, Grenada. 3. Department of Urology, Stony Brook University Medicine, Stony Brook, Southampton, New York. 4. Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, New York. 5. Department of Urology, Icahn School of Medicine at Mount Sinai, New York. 6. Department of Men's Wellness Program, Mount Sinai Health System, New York, NY, USA.
Abstract
BACKGROUND: Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms. METHODS: A MEDLINE® database search of the current literature was guided using combination of "prostate" with the following terms: intravesical prostatic protrusion, bladder trabeculation, bladder outlet obstruction, lower urinary tract symptoms, alpha blockers, transrectal ultrasonography, and prostatectomy. RESULTS: Although IPP can be identified via a variety of imaging modalities, it is easily detected via transrectal ultrasonography (TRUS). Failing to detect IPP promptly by TRUS may result in refractory symptoms of benign prostatic hyperplasia, as the condition may not respond to typical α1-adrenoceptor antagonist therapy. In addition, depending on grade, IPP can influence outcomes and complications of prostatectomies. CONCLUSION: Upon report of lower urinary tract symptoms, initial performance of TRUS along with digital rectal examination prevents delay in the appropriate evaluation and management of prostatic diseases.
BACKGROUND: Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms. METHODS: A MEDLINE® database search of the current literature was guided using combination of "prostate" with the following terms: intravesical prostatic protrusion, bladder trabeculation, bladder outlet obstruction, lower urinary tract symptoms, alpha blockers, transrectal ultrasonography, and prostatectomy. RESULTS: Although IPP can be identified via a variety of imaging modalities, it is easily detected via transrectal ultrasonography (TRUS). Failing to detect IPP promptly by TRUS may result in refractory symptoms of benign prostatic hyperplasia, as the condition may not respond to typical α1-adrenoceptor antagonist therapy. In addition, depending on grade, IPP can influence outcomes and complications of prostatectomies. CONCLUSION: Upon report of lower urinary tract symptoms, initial performance of TRUS along with digital rectal examination prevents delay in the appropriate evaluation and management of prostatic diseases.
Authors: Jong Wook Kim; Mi Mi Oh; Hong Seok Park; Jun Cheon; Jeong Gu Lee; Je Jong Kim; Du Geon Moon Journal: Urology Date: 2014-09-08 Impact factor: 2.649