Anatomical endoscopic enucleation of the prostate (AEEP) outcomes for benign prostatic hyperplasia may vary with prostate anatomy. This study evaluates associations of intravesical prostatic protrusion (IPP) and prostatic urethral angle (PUA) with postoperative urinary function improvements.

This study analyzed 178 patients who had bipolar enucleation of prostate or Thulium laser enucleation for BPH, with at least 6 months follow-up. Patients were grouped by the size of intravesical prostatic protrusion (IPP): mild (≤5 mm, n=16), moderate (5–10 mm, n=73), and severe (>10 mm, n=89). Postoperative outcomes like urinary flow rate (Qmax), IPSS, quality of life (QoL), and post-void residual urine volume (PVR) were measured. Pearson correlation was used to assess the relationship between IPP, PUA, and outcomes.

The Pearson correlation coefficient showed no significant relationship between prostatic urethral angle and surgical outcome factors. However, a significant correlation was found between IPP size and Qmax at three months postoperatively, as well as postvoid residual urine at six months. When comparing surgical parameters across IPP groups, significant differences in Qmax (p=0.016 and 0.038) was observed between group 1 and both groups 2 and 3. PVR showed significant differences only between group 1 and group 3 (p=0.044). Additionally, at two weeks postoperatively, IPSS-V (voiding subscore) and QoL scores showed significant differences between group 1 and both groups 2 and 3 (p=0.009 and 0.005 for IPSS-V; p=0.008 and 0.035 for QoL). At six months postoperatively, significant differences in Qmax and PVR were observed between group 1 and both group 2 and group 3 (p=0.038 for Qmax; p=0.014 for PVR). Larger IPP groups had greater postoperative changes in Qmax, QoL, PVR, and IPSS-V.

IPP significantly predicts outcomes after AEEP for BPH. Larger IPP correlates with greater improvements in Qmax, QoL, PVR, and IPSS-V. In contrast, PUA does not correlate with surgical outcomes.