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What causes swelling and tenderness in lower left abdomen?

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General Surgeon
Practicing since : 2008
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Male, age 65: minor swelling + mild tenderness lower-left area of abdomen (just above/left of penis-shaft origination) -- apparent after a confluence: 1) very low-weight squats at gym, 2) stretching that opens up pelvis (to reduce discomfort from L4-L5), 3) sexual activity. Questions: is swelling possibly due to inguinal hernia or inguinal canal strain (?) swollen lymph nodes (?) irritation of the vas deferens (?) or spermatic cords (?) or slight enlargement of prostate (?) and is one more likely than another? Your thoughts? Thank you, XXXXXXX
Posted Sat, 15 Mar 2014 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 54 minutes later
Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. Groin area is where few things are present that can cause diagnostics problems. We have here inguinal canal entrance, spermatic cord, adductor muscles tendons, lymph nodes. Any issue of mentioned structures can give pain and swelling in the groin. Here are some characteristic symptoms of each: 1. Inguinal hernia gives pain in the middle of the groin. The pain aggravates while lifting heavy objects, coughing or pushing hard on stool. There should be a lump palpable, more visible when standing and coughing. 2. Spermatic cord issues (inflammation, varices) gives usually pain radiating to the one side testis. Swelling is rather rare symptom. 3. Inflammation of the adductor of the thigh is an issue which is strongly associated with physical activity (running, bike riding, lifting or stretching). The pain is localized very close to the testis (not in the middle of groin) where the bone can be palpated. The pain appears only when moving the leg in specific direction. 4. Enlarged lymph nodes can give round shaped, multiple, hard lumps in the middle of groin. It can be movable and painful. Swelling can be really large. The pain is not associated with coughing or physical activity. The best way to diagnose it is to have ultrasound of this area and physical examination. Hope this will help. Feel free to ask further questions. Regards.
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