title: [Clinical impact of the intravesical prostatic protrusion: a review by the LUTS committee of the French Urological Association].
abstract: BACKGROUND
  Intravesical prostatic protrusion (IPP) is a protrusion of the lateral and/or median prostatic lobes into the bladder lumen. IPP can be estimated by suprapubic ultrasound.
  
  
  METHODS
  A literature search was conducted in Pubmed/MEDLINE database using the following keywords: intravesical prostatic protrusion; benign prostatic enlargement; treatment outcome; ultrasonography.
  
  
  RESULTS
  There are 3 grades of IPP: grade 1, 2 and 3 respectively if IPP ≤ 5mm, if 5-10mm, and if >10mm. IPP was a better prognosis factor than PSA and prostate volume for bladder outlet obstruction (BOO) with a sensibility of 80% and a sensitivity of 68% for grade 3. The progression risk of BOO increased with IPP (grade 1: OR=5.1 [95%CI: 1.6-16.2] and grade ≥ 2 OR=10.4 [95%CI: 3.3-33.4]). IPP was a predictive marker of failure of trial off catheter in patients with acute urinary retention with a 6 folds higher risk for grades ≥ 2. IPP was a prognosis factor for tamsulosine efficacy: 78% of patients with grade ≤ 2 had an improvement >35% of the IPSS-score versus 58% for grade >3 (P<0.01). Patients with grade >3 and a PV< 40cc had a poorer response to tamsulosine. After TURP, IPSS was more improved for grade ≥ 1 with an OR=3.43 (95%CI: 1.03-11.44, P=0.045).
  
  
  CONCLUSIONS
  IPP can be a useful marker for the management of LUTS/BPH.
authors.affiliation: Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France. Electronic address: souhil.lebdai@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Lebdai
authors.affiliation: Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Ammi
authors.affiliation: Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Bigot
authors.affiliation: Service d'urologie, hôpital Tenon, 75020 Paris, France.
authors.forename: J-N
authors.initials: JN
authors.lastname: Cornu
authors.affiliation: Service d'urologie, CHU de Rennes, 35033 Rennes, France.
authors.forename: R
authors.initials: R
authors.lastname: Mathieu
authors.affiliation: Service d'urologie, CHU de Limoges, 87042 Limoges, France.
authors.forename: A
authors.initials: A
authors.lastname: Descazeaud
authors.affiliation: Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
authors.forename: A-R
authors.initials: AR
authors.lastname: Azzouzi
mesh_terms: D006801:Humans; D053685:Laser Therapy; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013449:Sulfonamides / Q000627:therapeutic use; D000077409:Tamsulosin; D020728:Transurethral Resection of Prostate; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology* / Q000628:therapy; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D064804:Urological Agents / Q000627:therapeutic use
chemical_list: D013449:Sulfonamides; D064804:Urological Agents; D017430:Prostate-Specific Antigen; D000077409:Tamsulosin
keywords: Benign prostatic enlargement; Benign prostatic hyperplasia; Benign prostatic obstruction; Hypertrophie bénigne de la prostate; Intravesical prostatic protrusion (IPP); Lobe médian; Low urinary tract symptoms (LUTS); Median lobe; Protrusion prostatique intravésicale; Symptômes du bas appareil urinaire