Objective: Benign prostatic enlargement (BPE) leads to advancing lower urinary symptoms, and acute urinary retention (AUR) affects a significant proportion of men undergoing prostate surgery. This study evaluates the relevance of intravesical prostatic protrusion (IPP) in predicting trial without catheter (TWOC) success for AUR patients with BPE. Methods: A prospective observational study was conductedfrom February 2022 to January 2023.Data from patients≥45years old with AUR from BPE, requiring IPP on suprapubic ultrasound was collected and evaluated. Results: A total of 112 patients, with mean age of 63.22 years were included. The mean values of retention volume, prostate volume and IPP werereported 722.06 ml, 60.24 cc7.32 mm, respectively.TheTWOC was successful in 77 (68.75%) patients.Odds ratio (OR) for successful TWOC in patients with IPP grade 1 and grade 2 were2.3 (95% CI: 3.682-31.901) and 1.5 (95% CI: 1.465-15.608) times greater compared to grade 3, respectively. At 3-month follow-up, success rates for grades 1, 2 and 3 were 54.54%, 19.48%, and 9.09%, respectively.The odds of AUR at 3-month follow-up were 1.4 times lower for patients with IPP grade 1 and 0.265 times higher for those with IPP grade 2 compared to grade 3.The odds of successful TWOC were 1.7 times higher in retention volume grade 1 compared to grade 2, and 1.56 times higher in prostate volume grade 1 compared to grade 2. Conclusion: The measurement of IPP by suprapubic ultrasound proves to be a valuable parameter for predicting successful TWOC in patients with AUR due to BPE.