Presentation
Metastatic prostate cancer with persistent hematuria. Patient on chemo-radiotherapy management.
Patient Data











An extensively large heterogeneous, irregularly outlined and hypervascular prostatic tumor that continues and is inseparable from the prostate gland inferiorly that progresses superiorly and fills three-quraters of the urinary bladder lumen is noted. The lesion, including the prostate gland, measures approximately 523 grams (trans-abdominally) and is peripherally lobulated. The pre-micturition bladder capacity of 146 cc and the immediate post-void bladder volume of 60 cc.
Unilateral right-sided hydroureteronephrosis (grade III). No gross pelvic adenopathy sonographically.
Case Discussion
Diffuse and extensive globular enlargement of the prostate gland with bladder invasion in a patient with known prostate cancer presents with persistent hematuria with the patient unable to control the urge to void and maximally only able to hold up to 146 cc pre-void volume. There is unilateral right-sided ureterohydronephrosis (grade III). Bilateral percutaneous nephrostomy catheter tubes are noted in situ bilaterally.