Digital illustration of a prostate intruding into the bladder, representing Intravesical Prostatic Protrusion (IPP).

Worried About Leaks After Prostate Surgery? What You Need to Know About IPP

Mira Elwood in Health & Wellness December 2025 • 3 min read.

"Discover how intravesical prostatic protrusion (IPP) affects urinary continence after robot-assisted prostatectomy and what it means for your recovery."

Over the past decade, robot-assisted laparoscopic radical prostatectomy (RALP) has become a popular option for treating localized prostate cancer. This advanced technique offers surgeons a magnified view and greater precision, especially when working around key anatomical structures. Procedures like bladder neck dissection and nerve-sparing (NS) dissection benefit greatly from this technology.

One factor that can add complexity to RALP is the presence of a median prostatic lobe, which some studies suggest may increase the risk of positive surgical margins. However, a more objective measure called intravesical prostatic protrusion (IPP) has emerged as a predictor of bladder outlet obstruction in individuals with benign prostatic hyperplasia. While IPP's role in RALP hasn't been extensively studied, it may significantly affect urinary continence—a key functional outcome after surgery.

A recent study aimed to explore the relationship between IPP grade and the outcomes of RALP, focusing particularly on how IPP affects the recovery of urinary continence. The results offer valuable insights for both surgeons and patients, helping to better understand and manage expectations after prostate surgery.

What is Intravesical Prostatic Protrusion (IPP) and How Is It Measured?

Digital illustration of a prostate intruding into the bladder, representing Intravesical Prostatic Protrusion (IPP).

Intravesical Prostatic Protrusion (IPP) refers to how much the prostate protrudes into the bladder. It is measured using transrectal ultrasound (TRUS), where the vertical distance from the tip of the protrusion to the base of the bladder is assessed. This measurement helps doctors determine the degree of obstruction the prostate might be causing.

The study categorized IPP into three grades:

Grade 1: IPP ≤ 5 mm
Grade 2: 5 mm < IPP ≤ 10 mm
Grade 3: IPP > 10 mm

These grades allow for a standardized assessment, which can then be correlated with surgical outcomes and patient recovery.

Making Informed Decisions About Prostate Surgery

If you're exploring RALP as a treatment for prostate cancer, understanding IPP and its potential impact on urinary continence is essential. Discussing your IPP grade with your urologist can provide a clearer picture of your likely recovery and help you make informed decisions about your treatment plan. With the right information and a skilled surgical team, you can approach prostate surgery with greater confidence and realistic expectations.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3349/ymj.2016.57.5.1145, Alternate LINK

Title: Urinary Continence After Robot-Assisted Laparoscopic Radical Prostatectomy: The Impact Of Intravesical Prostatic Protrusion

Subject: General Medicine

Journal: Yonsei Medical Journal

Publisher: Yonsei University College of Medicine

Authors: Jung Ki Jo, Sung Kyu Hong, Seok-Soo Byun, Homayoun Zargar, Riccardo Autorino, Sang Eun Lee

Published: 2016-01-01

Everything You Need To Know

What is Intravesical Prostatic Protrusion (IPP), and why is it important?

Intravesical Prostatic Protrusion (IPP) is the extent to which the prostate extends into the bladder. The importance lies in its potential impact on urinary continence following a Robot-Assisted Laparoscopic Radical Prostatectomy (RALP). IPP is graded using transrectal ultrasound (TRUS), which helps to determine the degree of bladder outlet obstruction. Understanding your IPP grade is crucial because it can influence your recovery and surgical outcomes.

What is Robot-Assisted Laparoscopic Radical Prostatectomy (RALP)?

Robot-Assisted Laparoscopic Radical Prostatectomy (RALP) is a minimally invasive surgical procedure that uses a robot to remove the prostate gland. This technique offers surgeons a magnified view and greater precision. The procedure benefits from technology due to advanced techniques such as bladder neck dissection and nerve-sparing (NS) dissection. Knowing about this procedure is important as it is a popular option for treating localized prostate cancer.

Why is urinary continence important, and how is it related to Intravesical Prostatic Protrusion (IPP)?

Urinary continence is the ability to control the flow of urine. It is a key functional outcome after a Robot-Assisted Laparoscopic Radical Prostatectomy (RALP). The presence of Intravesical Prostatic Protrusion (IPP) may significantly affect this continence. Discussing your IPP grade with your urologist can provide a clearer picture of your likely recovery and help you make informed decisions about your treatment plan.

How is Intravesical Prostatic Protrusion (IPP) measured?

IPP is measured using transrectal ultrasound (TRUS). During the procedure, the vertical distance from the tip of the IPP to the base of the bladder is assessed. The study categorized IPP into three grades: Grade 1 (IPP ≤ 5 mm), Grade 2 (5 mm < IPP ≤ 10 mm), and Grade 3 (IPP > 10 mm). These grades are used to correlate with surgical outcomes and patient recovery, offering a standardized assessment.

How can I use information about Intravesical Prostatic Protrusion (IPP) to make informed decisions about prostate surgery?

If you are exploring Robot-Assisted Laparoscopic Radical Prostatectomy (RALP), discuss your Intravesical Prostatic Protrusion (IPP) grade with your urologist. This can provide insight into your recovery, helping to make informed decisions about your treatment plan. You can approach prostate surgery with greater confidence and realistic expectations.