Anonymous on September 14, 2011

When I have an erection for a long time, I have pain and swelling near my genitals. What could this be?

When I have an erection for a long time (and when I orgasm), I have a pain and a swollen lump slightly above and right of my genitals. What could this be?

answered by Lisa Oldson, MD on September 14, 2011

Thanks for sharing your question with us.

Because the pain you describe could be caused by a number of things, my first suggestion is that you see your regular doctor for a definite diagnosis. Meanwhile, in preparation of your doctor’s visit, here are my best thoughts on possible causes of your symptoms.

A groin lump can indicate a hernia. Most people have heard of hernias, but they don’t always know what they are. Hernias occur when a part of the small intestine pokes through the muscles of the abdominal wall. This can cause a small, tender lump in your lower abdomen. Usually, your abdominal muscles do a good job of keeping the small intestine where it’s supposed to be, but sometimes a tear or separation occurs in the muscle (often from heavy lifting, but sometimes due to genetics) and the small intestine pokes out.  

If you have a hernia, you probably experience pain more often if you cough, lift a heavy object or bend over, and the pain might be worse at the end of the day. Usually, you notice the bump more prominently when you’re standing up.

Be aware that a hernia near the groin (called an inguinal hernia) won’t go away on its own. If it turns out that you have a hernia, it’s possible that your doctor will decide surgery is the best way to address the problem. (But don’t worry...90% of hernia repair surgeries in the United States are outpatient, which means that most people go home the same day of the surgery.)

Another cause of lumps near the groin are swollen lymph nodes. We have lymph nodes all around our bodies, but there are some in the groin area in the lower part of the abdomen above the leg crease. Painful, swollen lymph nodes may indicate that you have an infection...or they can indicate other health problems, like cancer or a tumor.

Sexually transmitted diseases (STDs), notably HIV, can also cause swollen lymph nodes. So, depending on your sexual history and level of risk for STDs, you may want to consider getting tested for a panel of common STDs. If you’d like to learn more about STD risk factors, symptoms and testing, see our Expert Guides to STD Basics.

Of course, lymph nodes may also swell as a result of medication or a recent immunization. So, again, you’ll need to speak with your doctor to find out whether swollen lymph nodes are the cause of your symptoms, and ⎼ if so ⎼ whether you have any related health problems that need to be addressed.

Some other possible causes of your groin lumps are harmless cysts or fatty growths, an infection or an allergic reaction.

I hope this information has helped you understand some of the possible causes of the painful, swollen lump in your genital area. With your doctor’s help, I hope that you’ll soon identify the cause and treatment of your discomfort.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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