Despite stage migration to more organ-confined disease in the era of prostate-specific antigen, the complications of advanced prostate cancer are still relatively common. Urinary tract obstruction in advanced and metastatic prostate cancer can have a varied presentation, because it may occur in multiple anatomic locations at any point in the natural history of the disease. In all cases, management depends on the current stage of disease, technical feasibility of potential therapeutic interventions, and overall prognosis of the patient. This review highlights a practical approach to the evaluation, diagnosis, and management of obstructive uropathy from prostate cancer.
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