A 71-year-old male with a past medical history of prostate cancer s/p radiation treatment seven years ago. He presented to the emergency department with acute onset pain in the suprapubic region. He denied associated symptoms of nausea, vomiting, urinary urgency, urinary frequency and dysuria. He was afebrile and hemodynamically stable on presentation. On abdominal examination he had suprapubic tenderness. Initial basic lab work including CBC, BMP and lactate levels were normal. Urinalysis was negative for any signs of infection.