Hello, Thanks for posting on HCM, There are many possible causes of lower abdominal pain and the doctor examining need to consider the most common and focus on trying to rule them out. In most women I meet in my clinical setting, they usually turn to suffer from either diseases of pelvic origin which could be PID, fibroid/cysts (which you mentioned had already been ruled out), urinary tract diseases (could be cystitis, ureteritis, pyelonephritis, stones etc) and digestive diseases (could be infection, colopathy, inflammatory or irritable bowel, dyspepsia etc). So your doctor needs to run some tests aiming at trying to identify each of the above conditions (some will only be determined by excluding the others). As for the lump, I am suspected that you might be having hypogastric hernia (which could even explain the lower abdominal pain you could had been having). As strangulated hernia could present with stabbing pains that go on and off. In that case, your doctor will need to confirm this and perform a surgery to repair the hernia. Hope this helps