Prostate volume 77 mL. PSA density 0.61 ng/mL.
Extensive PI-RADS 5 changes in the peripheral zones (right more than left) most pronounced posterior in the TRUS biopsy field.
Neurovascular bundle, extracapsular and seminal vesicle invasion with prostatic tissue abutting, if not invading the anterior aspect of the rectum.
Gross pelvic and left para-aortic lymphadenopathy.
No bone metastases.
Large right inguinal hernia containing bowel. Small left inguinal hernia.