My 95 year old mother had a CT scan last August, then an ultrasound in Jan of this year. Her symptoms were daily mild nausea, lack of appetite, hard little stomach (but she also has extreme kyphosis due to multiple compression fractures over the last 5 or 6 years). The report showed an 8.4cm cyst on her uterus, which she doesn’t have, so PA nurse explained it must be on her bladder. The ultrasound in Jan. showed it had grown to 9.6cm and that report called it a mass. She has started getting a pain in her groin from time to time that is relieved when she urinates. Both reports showed hydronephrosis of one kidney. Her blood work is good but about 9 months ago her potassium was up slightly and they had monitored that. In the past 3 or 4 months she has developed really bad edema in her legs and feet; she had always had some, mostly her ankles and feet but now its that way well above her knees. She has gone from hovering at about 98 -100 lbs to 115 at an appointment earlier this week. That appointment was with her Primary doctor. I hand delivered the reports (which had been done by a gastro doctor) and called many times to ask if she was going to refer my mom to a urologist. I kept getting the answer that they were waiting for more information from the gastro doctor. I finally got her an earlier than usual appointment to come in to see the Primary doctor and she said very little about the reports of the cyst/mass and concentrated on the fact that her blood work and recent urinalysis was all good. My mother has atrial fibrillation and sees a cardiologist also. I asked did she also need to see her cardiologist sooner than her regular appointment, 2 months away. She said no, that she would prescribe a stronger diuretic, and suggested another ultrasound in about 6 weeks to monitor the cyst/mass (almost 10 cm!) Should I just make an appointment for her with a urologist myself? Am I overreacting? I know my mother would not put herself through surgery, she has said so, so is it reasonable for her doctor to feel like there is nothing to do for her so why send her and increase her anxiety about it all. I almost get the feeling that the doctor, who both my mother and me have always liked, thinks she is at the end so just let it all be. What should I do?

The question that you ask is a urological question.  I am a nephrologist and have no experience with surgical evaluation and treatment of kidney tumors.  This should be directed to a urologist who is a surgeon.  Evaluation of masses and tumors in the elderly can be very challenging.  In some cases, the tumor is observed to see if it grows.  I cannot offer any other advice in this circumstance.  I believe the best person to offer advice is the primary care physician (PCP) who has known your mother for the longest time.

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