Case Presentation A 16-year-old female presented with worsening dysuria, bladder fullness, and decreased urinary output for 4–5 hours. She also reported constipation, rectal pain, and a sensation of a lump in the rectum while straining. Over the past few months, she experienced recurrent episodes of similar symptoms, often around menstruation, with spontaneous resolution.
Medical History Past medical history: Unremarkable, except for a urinary tract infection five months prior (treated successfully with antibiotics) Menstrual history: Menarche one year prior; has regular menstrual cycles; her last menstrual period was 14 days before presentation. Sexual history: Denied sexual activity; no history of sexually transmitted infections Substance use: Occasional marijuana use Emergency Department Check Suprapubic fullness and mild tenderness Rectal exam: Mild hemorrhoids, no fecal impaction…
