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Tender lump (connected to vein?), swells with ejac.

I've read your advice to others and I appreciate your thoroughness and professionalism.

Here is my question.

I feel what appears to be a stone-like lump in my groin (not on a testicle), roughly at the right base of my scrotum. It seems to roll around and  be connected to a vein, but I am not 100% sure if it is on a vein (but yes, a big vein seems to lead to it, and the lump does "roll" if pushed).

(I first noticed it 8 months ago, a few days after an unusually sustained sexual session in which I was close to ejaculating many times, but did not. I am not 100% sure if that is coincidental, but it seems likely.)

It is the size roughly of a green pea and has not seemed to increase in size since I first noticed it 8 months ago. It has not, however, decreased either.

Occasionally I have felt an aching in that area, and it was only a couple of months ago that I realized the area becomes tender -- and the "pea-shaped swelling" seems to become a little more inflamed -- if I ejaculate more than every 4-5 days.

So lately I have been trying to keep ejaculations as infrequent as possible in hopes it will help.

My general practitioner emailed me awhile back saying it is probably a phlebolith, but she cannot say for certain.

Now I believe it is a variocele or has to do with the spermatic cord?

I am 35 years old, otherwise in good health, have never had an STD, have been on Propecia for 5 years, but have no health insurance (or I would see a urologist).

If it is a phlebolith (or a variocele), will it go away? How long will it take?

Any additional information or insight would be appreciated.

Thank you!
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233190 tn?1278549801
MEDICAL PROFESSIONAL
Either possibility can be considered.  The test to give a more definitive diagnosis would be an ultrasound which can evaluate for both of these conditions, as well as more worring causes of the symptoms.

Typically either condition can be managed conservatively with medications - such as anti-inflammatory medications.  Phleboliths can occur with greater frequency as one ages.  

If the symptoms worsen despite medications, there are surgical procedures that can help manage the symptoms.  

These options can be discussed with your urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
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