A 74-year-old man presented with a 2-day history of severe, steady pain radiating down to the lower abdomen and left testicle. He has had urinary frequency, nocturia, hesitancy, and urinary dribbling for several years with slight worsening with time. CT scan revealed left-sided hydronephrosis (Figure 69-1). In this patient, an irregular mass was seen at the left ureterovesical junction compressing the bladder. Prostate cancer was found on biopsy.