Features of age related benign prostatic hyperplasia present. Two nodules in central gland show diffusion restriction, whilst bilateral peripheral zones show T2 hypointensity. This warrants spiking PIRADS category to 4 and suggesting a PSA correlation and a transrectal guided prostatic biopsy to rule out neoplasm. 

The urinary bladder outpouching could be a long standing sequel to bladder outlet obstruction.