Urinary Retention: This is often the most common cause of a suprapubic mass, especially in older males or individuals with urinary tract obstruction. The mass is usually a distended bladder.

Uterine Fibroids: In females, uterine fibroids can present as a suprapubic mass, especially if they are large.
Ovarian Cysts: Large ovarian cysts can also present as a suprapubic mass.
Bladder Diverticulum: Although less common, a large bladder diverticulum can feel like a mass in the suprapubic area.
Pregnancy: In the later stages, pregnancy can cause the uterus to enlarge and present as a suprapubic mass.

Appendicitis: Although appendicitis typically presents with right lower quadrant pain, a retrocecal appendix can sometimes cause pain or a mass in the suprapubic area, especially if it ruptures and forms an abscess.
Ectopic Pregnancy: A ruptured ectopic pregnancy can cause severe abdominal pain and potentially a palpable mass if significant bleeding occurs.
Bladder Cancer: While less common, bladder cancer can cause a palpable mass in the suprapubic area, especially if it is large or has invaded the bladder wall.
Lymphoma: Abdominal lymphoma can cause masses in various locations, including the suprapubic area, especially if lymph nodes are involved.

Sarcomas: Soft tissue sarcomas in the pelvis can present as a suprapubic mass, though they are rare.
Neurogenic Tumors: Tumors arising from the nerves in the pelvis, such as neurofibromas or schwannomas, can occasionally present as a suprapubic mass.
Desmoid Tumors: These are rare, benign tumors that can occur in the abdominal wall or pelvis and might be felt as a suprapubic mass.
Roundworm Infestation (Ovarian or Uterine): In rare cases, especially in endemic areas, roundworms can infest the female reproductive organs and cause a mass.