The prostate in this patient was enlarged with multi focal areas of mineralization. This is strongly suggestive for prostatic carcinoma. Ultrasound-guided FNA is recommended to confirm. Significant power Doppler vascularity was noted to the prostate. The prostate measured 3.76 x 2.1 cm with cauliflower projection into the cystourethral junction and invasion into the post prostatic urethra. Deviation of the descending colon was noted. This is owing to the prostatic pathology, which is responsible for the clinical signs.