Bladder Pressure, Microscopic Hematuria, family history of bladder cancer

I'm a 56-year old female with a long history of polycystic kidney disease, UTIs and persistent microhematuria. My last cystoscopy was in 2002 when I had an oophorectomy after an apparent complex cyst on an ovary was found incidentally during a transvaginal ultrasound (to help establish why I was having the persistent microhematuria). The cysts were benign. I had a hysterectomy in 1990.

For the past month, I've had bothersome persistent steady pressure (not pain exactly) in the area of my bladder. There hasn't been any change in urination (frequency, amount, flow, pain). I make the occasional night-time bathroom trip (... pretty normal for my age, I suppose). My brother was diagnosed 10 years ago with bladder cancer (first symptom was painless blood in urine).

Because I am vulnerable to infections, although less frequently in recent years, I have dipsticks on hand. The pressure has prompted me to check my urine and the past several days there has a fairly small amount of infection (relatively speaking), the usual microhematuria, high specific gravity, only a small amount of protein, everything else is normal. I've been sweating a lot and nauseaous.

We live in a small town and hours from any real medical care. Any thoughts? Thanks!