Not Just a Side Effect: A Case of Minor Urinary Symptoms Concealing a Large Pelvic Mass

Presentation Goal: The goal of this presentation is to emphasize the importance of maintaining clinical curiosity and utilizing diagnostic imaging when patient symptoms do not align with common explanations. This case illustrates how focusing too narrowly on a presumed cause can obscure the broader clinical picture, reminding providers not to “miss the forest for the trees” when evaluating urinary symptoms in female patients.

Presentation Description: This case involves a 51-year-old female who presented to the outpatient, urology clinic with feelings of incomplete bladder emptying and nocturia. The patient attributed her symptoms to an adverse effect of an inhaler she had been using, as her symptoms improved after switching to another brand of inhaler. But symptoms eventually progressed to acute urinary retention. Clinical curiosity and appropriate imaging revealed a large, nonmalignant pelvic mass causing the patient’s symptoms.
This presentation highlights the importance of maintaining a broad clinical perspective and not becoming narrowly focused on only the most common differential diagnoses. Attendees will explore how thorough evaluation, good history-taking, and imaging can uncover unexpected diagnoses, improve patient outcomes, and reinforce the value of seeing the “forest’ rather than just the “tree”.