This prospective cohort study evaluated whether transabdominal ultrasound measurement of intravesical prostatic protrusion predicts symptom severity and response to medical therapy in men aged 50 years or older with lower urinary tract symptoms secondary to benign prostatic hyperplasia. At baseline, participants underwent clinical evaluation, laboratory assessment including prostate-specific antigen, symptom scoring using the International Prostate Symptom Score and quality of life index, uroflowmetry, and transabdominal ultrasonography to measure prostate volume, bladder parameters, post-void residual urine, detrusor wall thickness, and intravesical prostatic protrusion. Participants were grouped by intravesical prostatic protrusion grade (less than 5 millimetres, 5 to 10 millimetres, and greater than 10 millimetres) and were followed for six months with reassessments at three and six months to evaluate response to medical therapy and identify patients who required escalation of treatment or surgical intervention.

Inclusion Criteria:

• Male participants aged 50 years or older.
• Lower urinary tract symptoms secondary to benign prostatic hyperplasia.
• Moderate to severe symptoms with International Prostate Symptom Score 15 to 35.
• Prostate volume 30 to 100 millilitres.
• Maximum urinary flow rate less than 15 millilitres per second.
• No hydronephrosis due to bladder outlet obstruction.
• Normal prostate-specific antigen or normal free-to-total prostate-specific antigen ratio.

Exclusion Criteria:

• History of prostate, bladder, or lower urinary tract surgery.
• Neurological disease affecting lower urinary tract function.
• Active urinary tract infection and/or symptomatic urinary tract stones.
• Post-void residual urine volume greater than 200 millilitres.
• Urethral stricture.
• Prostate cancer or bladder cancer.

Men aged 50 years or older with moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia attending urology outpatient services at Ain Shams University Hospitals.

De-identified individual participant data collected during the study will be shared, including baseline and follow-up measurements (International Prostate Symptom Score and quality of life index, uroflowmetry parameters, transabdominal ultrasound parameters including intravesical prostatic protrusion, prostate volume, post-void residual urine, and detrusor wall thickness), along with a data dictionary. Direct identifiers will be removed and data will be coded prior to sharing.

De-identified data will be available beginning 6 months after study completion and will remain available for 5 years.

Data will be shared with qualified researchers upon reasonable request and after review and approval by the study investigators and the institutional administration. Requesters must submit a proposal outlining objectives and planned analyses and must sign a data use agreement that prohibits re-identification and limits use to the approved purpose.