Painful Lump on Side of Groin

A painful lump in the groin in females and males, specifically located on one side, is most likely caused by an enlarged lymph node, a skin infection like an skin abscess or cyst, an infected ingrown hair on the groin, or a symptom of a sexually transmitted infection. Read below for associated symptoms, other causes, and treatment options for your painful lump on one side of the groin.

7 most common causes

Skin Abscess

Illustration of various health care options.

Skin cyst

Illustration of various health care options.

Pimples

Illustration of a person thinking with cross bandaids.

Enlarged lymph nodes in the groin

Indirect Hernia

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Groin Hernia

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Boil (furuncle)

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Most common questions

A painful groin lump could be caused by a few different things, including an abscess, hernia, an enlarged lymph node, or a boil. It is recommended to seek medical attention to determine the specific cause and receive proper treatment.

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Having a painful groin lump is not necessarily an emergency, but if you are also experiencing redness, fever, flu-like symptoms, or it is growing in size, it may be an emergency and you should seek medical attention immediately.

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You should visit a medical professional within the next day to discuss your symptoms, as the lump could be an abscess or an enlarged lymph node. There are scenarios where you can manage your symptoms without seeing a doctor (for example if the lump is a boil), but it’s best to discuss with your healthcare provider to be sure.

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Depending on the cause of the lump, treatment options may include applying a warm, wet compress to the affected area, antibiotics, or possibly surgery to drain an abscess or repair a hernia.

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Hallmarks of a painful lump in the groin

A groin lump is a swelling in the area where the upper leg meets the pelvis. Depending on the cause, a painful lump in the groin may go away on its own or may need to be treated by a medical professional.

Common characteristics of a painful lump in the groin

Groin lumps can have any of the following characteristics:

• Large or small
• Soft or firm
• Mobile: This means it moves when you touch or press it.
• Fixed: This means it feels stuck in its location.
• Consistent in size or growing and shrinking with activity or rest

Common accompanying symptoms of a painful groin lump

Groin lumps can also be associated with:

• Redness
• Pain or tenderness
• Numbness
• Skin that feels hot to the touch in the area of the lump
• Flu-like symptoms
• Fever
• Abdominal pain
• Abnormal discharge or fluid from the vagina or penis

Duration of symptoms

A painful lump in one side of the groin may be short- or long-term depending on the cause.

• A groin lump may last for only a few days before going away on its own or you may notice that it persists for a week or more.
• You may also notice that the groin lump comes and goes, appearing when you cough or strain and disappearing when you rest or lay down.

Are painful groin lumps serious?

The severity of groin lumps depends on the cause and the duration of the symptom(s).

• If it is self-resolving: If your groin lump goes away on its own, this is typically a sign that it is not serious.
• If you also have a fever: If you have a large groin lump that is associated with redness, pain, numbness, and especially fever, you should be seen by a medical provider.
• If it is growing or fixed: Groin lumps that grow over time or feel firm and fixed in place should be evaluated by a medical professional.
• If pain increases with exertion: Even if your groin lump seemed to go away with rest and only be exacerbated by activity or straining, you should see a medical provider immediately, especially if the pain starts to increase or is persistent.

9 causes of a painful lump in the groin

There are many potential causes for a painful groin lump. Some of these causes are related to infection and injury but sometimes a groin lump can be caused by changes in your body’s anatomy or abnormal cell growth.

Infection-related causes

Various infection-related causes that can lead to a painful lump in the groin include:

• Skin infection: Infections of the skin by bacteria or fungi can cause a painful groin lump. Sometimes the infection starts when a hair follicle gets infected (called folliculitis if it becomes more severe) and is often from shaving. If an open cut is exposed it can also become infected, leading to something called cellulitis, an infection of the skin and area under the skin. A skin infection that isn’t cleared up can lead to something called an abscess, which is a pocket pus that forms as your body tries to fight the infection.
• Lymph node enlargement: Lymph nodes are small glands where the cells that fight infections live. While reacting to infections caused by bacteria, fungi or viruses in and around the area of your groin, they can grow in size and appear as single or multiple lumps in the groin.
• Sexually transmitted infections (STI): Some STIs, like HIV (human immunodeficiency virus), genital herpes, and syphilis can cause your lymph nodes to enlarge, leading to painful groin lumps. Another STI, HPV (human papillomavirus), can cause groin lumps in the form of small, flesh – colored lumps in your groin area that may be itchy. Groin lumps from STIs can be accompanied by discharge from the vagina or penis and/or flu-like symptoms.

Anatomy-related causes

Hernias that appear as groin lumps occur when some of your abdominal tissue and/or intestines bulge out through a weak spot in your abdominal muscles. You may notice the bulge appear or become more painful and/or noticeable when you strain by coughing, sneezing, bending over, lifting a heavy object or having a bowel movement. Sometimes the bulge can be pushed back into place easily. Other times it gets strangulated or “stuck,” and this can be life-threatening as blood flow can be cut off to the section of your tissues or intestine that is bulging through.

Trauma or injury

Groin lumps can also be a symptom of injury or strain when too much stress has been put on the muscles of your groin. This can lead to muscle pain, swelling and cramping in reaction to the injury.

Abnormal cell growth

Sometimes a groin lump can be caused by abnormal growth of a variety of different cells that make up your body. These can include the cells that make up your blood system which can lead to leukemia or lymphoma that sometimes appear as swelling in the groin. For people with testicles, abnormal growth of the cells that make up the testiclescan also lead to swelling in and around the groin. Fat cells can also grow abnormally into harmless lumps called lipomas.

This list does not constitute medical advice and may not accurately represent what you have.

Skin cyst

A cyst is a small sac or lump, filled with fluid, air, fat, or other material, that begins to grow somewhere in the body for no apparent reason. A skin cyst is one that forms just beneath the skin.

It’s believed that skin cysts form around trapped keratin cells – the cells that form the relatively tough outer layer of the skin.

These cysts are not contagious.

Anyone can get a skin cyst, but they are most common in those who are over age 18, have acne, or have injured the skin.

Symptoms include the appearance of a small, rounded lump under the skin. Cysts are normally painless unless infected, when they will be reddened and sore and contain pus.

Diagnosis is made through physical examination. A small cyst can be left alone, though if it is unsightly or large enough to interfere with movement it can be removed in a simple procedure done in a doctor’s office. An infected cyst must be treated so that the infection does not spread.

Rarity: Common

Top Symptoms: skin-colored armpit bump, marble sized armpit lump, small armpit lump

Symptoms that always occur with skin cyst: skin-colored armpit bump

Urgency: Wait and watch

Pimple

Pimples are also called comedones, spots, blemishes, or “zits. ” Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.

Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.

Most susceptible are teenagers from about ages 13 to 17.

Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.

Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.

Diagnosis is made through physical examination.

Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.

Rarity: Common

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump

Symptoms that always occur with pimple: pink or red facial bump

Urgency: Self-treatment

Indirect hernia

A hernia occurs when an organ or internal body part bulges through the abdominal wall. In the case of indirect hernia, the hernia is a result an improperly failed deep inguinal ring after the testicle has passed through it.

A physician is needed to determine the course of treatment. A hernia reduction will be attempted, meaning that the bulging loop of intestine will be carefully pushed back, if possible. Then, your doctor will recommend surgery in some cases. Often, watchful waiting is the preferred route in minimally symptomatic hernias.

Groin hernia

A groin hernia, also called an inguinal hernia, means that a structure in the lower abdomen – a loop of intestine or a section of fat – has pushed through the muscles of the abdominal wall. This creates a bulge, or hernia, that can be seen and felt in the groin.

A hernia is caused by a weak spot in the abdominal wall muscles, which can separate under heavy lifting or repeated straining. The weakness may be inherited or may be from previous surgery, injury, or pregnancy.

Symptoms include a bulge low down in the abdomen, most visible when the person stands; and pain in the bulge with any strain on the abdominal muscles, such as lifting a heavy object or bending over.

A hernia will not heal on its own. There is the risk of serious complications if the blood supply to the herniated organ becomes reduced or cut off.

Diagnosis is made through physical examination and x-ray or CT scan.

A small hernia may need no treatment. A larger one can be repaired with surgery.

Rarity: Uncommon

Top Symptoms: pain in the lower right abdomen, pain in the lower left abdomen, groin pain, testicle pain, groin lump

Urgency: Primary care doctor

Groin abscess

An abscess is a buildup of pus under the skin that is caused by an infection. Redness and swelling may occur on the skin around the infected area.

You should consider visiting a medical professional within the next day to discuss your symptoms. An abscess can be evaluated with a physical exam, an abscess fluid sample test, and sometimes imaging. Once diagnosed, it can be treated with antibiotics or surgery to drain the abscess.

Rarity: Common

Top Symptoms: groin pain, constant groin lump, lump on one side of the groin, painful lump in one side of the groin, hard groin lump

Symptoms that always occur with groin abscess: lump on one side of the groin, constant groin lump

Urgency: Primary care doctor

Enlarged lymph nodes in the groin

Enlarged lymph nodes occur when the node becomes larger as it fills with inflammatory cells. This often is a result of an infection but can occur without a known cause.

You should discuss with a health care provider whether or not your lymph node needs to be checked. Enlarged lymph nodes will usually shrink on their own. To speed up the process, try applying a warm, wet compress to the affected area.

Rarity: Common

Top Symptoms: groin lump, movable groin lump

Symptoms that always occur with enlarged lymph nodes in the groin: groin lump

Symptoms that never occur with enlarged lymph nodes in the groin: fever, unintentional weight loss, hard groin lump

Urgency: Phone call or in-person visit

Boil (furuncle)

A furuncle, also called a boil, is infection of a hair follicle. The infection forms under the skin at the root of the hair and may occur anywhere on the body.

The infection is caused by bacteria, most often Staphylococcus aureus or “staph.” Irritation caused by clothes or anything else rubbing the skin can cause the skin to break down and allow bacteria to enter.

Staph bacteria are found everywhere. Frequent and thorough handwashing, and otherwise maintaining cleanliness, will help to prevent its spread.

Most susceptible are those with a weakened immune system; diabetes; and other skin infections.

Symptoms include a single bump under the skin that is swollen, painful, and red, and contains pus.

It is important to treat the boil, since infection can spread into the bloodstream and travel throughout the body.

Diagnosis is made through physical examination and sometimes fluid sample from the boil.

Treatment may involve incision and drainage of the infection, followed by creams to apply to the site of the boil and/or a course of antibiotic medicine.

Rarity: Uncommon

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump, constant skin changes

Symptoms that always occur with boil (furuncle): pink or red facial bump

Symptoms that never occur with boil (furuncle): fever

Urgency: Self-treatment

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body’s immune system. But some will need to be drained or lanced in a medical provider’s office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Rarity: Common

Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash

Symptoms that always occur with skin abscess: rash with bumps or blisters

Urgency: Primary care doctor

Groin hernia requiring a doctor’s examination

A groin hernia, or inguinal hernia, is the protrusion of an organ or other tissue – usually a loop of intestine – through a tear or weakness in the lower abdominal muscles. It can be easily felt beneath the skin, especially when the person is standing upright.

A groin hernia is most often found in men doing any kind of heavy lifting, though women can also be affected.

Symptoms include aching, burning groin pain with a sense of heaviness. The pain may be severe, especially on exertion. There may be an abdominal bulge that disappears when the patient lies on his/her back.

It is important to have a suspected inguinal hernia examined by a medical provider for possible treatment. A hernia can become strangulated, which means that its blood supply is cut off. A strangulated hernia is a medical emergency.

Diagnosis is made through patient history, physical examination, and sometimes ultrasound.

Treatment usually involves surgical repair of the hernia, although a small hernia may simply be monitored for any change.

Rarity: Rare

Top Symptoms: nausea, nausea or vomiting, fever, groin pain, groin lump

Urgency: Emergency medical service

Treatments for painful groin lumps

Treatment for painful lumps in the groin can begin at home. However, if you are unable to find relief, you should consult your physician for further recommendations and medical treatment.

At-home treatment

Various at-home treatments that you can try to alleviate symptoms of your painful groin lump include:

• Warm and cold compresses: These can help reduce pain and swelling if your groin lump is due to infection or trauma.
• Over-the-counter medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like Advil, Motrin, Naproxen and aspirin can help reduce pain, swelling, and redness because they work by reducing inflammation in your body. Acetaminophen (Tylenol) can also help with pain and fever but does not treat the inflammation.
• Fluid intake: If your groin lump is due to an infectious cause, increasing your fluid intake is critical in order to stay hydrated and keep your body strong enough to fight the infection, especially if you also have a fever.

Medical treatments

After consulting your physician, he or she may also recommend the following if conservative measures have been ineffective or your pain is persisting.

• Incision and drainage: If your groin lump is caused by an infection that has caused a collection of pus under your skin, a medical professional may need to cut a small hole (incision) in the skin overlying the bump in order to drain the pus collection.
• Antibiotics: You may also be prescribed an antibiotic in the form of a pill or cream/ointment in order to fight the infection if the groin lump is due to a bacterial or fungal cause.
• Surgery: If the groin lump is caused by an abnormal growth of cells, a doctor may recommend surgery to remove the lump, assess what kind of cells are causing the growth, and determine whether the growth is cancerous or not. If your groin lump is the result of a hernia a bulging of your abdominal tissue or intestines through a weakness in your abdominal muscles you may need surgery, especially if a hernia becomes strangulated or”stuck” and can no longer be pushed back inside. During the procedure, a surgeon pushes the tissue and intestines back into your abdomen and seals the hole or weakness where a hernia was bulging through.

Seek immediate treatment in the emergency room or call 911 for the following

If you experience these symptoms, you should seek treatment as soon as possible:

• Severe, sudden, or worsening pain and/or swelling
• Nausea and/or vomiting
• Redness that is worsening or spreading around the lump
• Fever
• Sudden loss of sensation
• Inability to pass gas or have a bowel movement

FAQs about painful groin lumps

Can groin lumps be caused by STIs?

Yes, certain sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) can cause groin lumps in the form of lymph node swelling. Your lymph nodes are small glands all over your body where the cells that fight infection live. In response to infection, the cells become more active which sometimes leads to swelling of the lymph nodes. The lymph nodes in your groin are on alert for infections that occur in and around your groin area and can become swollen after infection with STIs like HIV (human immunodeficiency virus), syphilis, or herpes, for example. Groin lumps associated with STIs can also be associated with abnormal genital discharge (fluid from the vagina or penis), flu-like symptoms, and pain or burning during sex or urination. HPV (human papillomavirus) can also cause genital warts, which are small, flesh-colored lumps in and around the genital and groin area.

Why does my groin lump appear after I work out?

Some groin lumps are caused by hernias, which occur when tissue from the abdomen and/or intestine bulges out through a weakness in the abdominal wall and into the groin area. Hernias become more noticeable when the pressure inside your abdomen/belly builds up, and this normally happens when you strain often during a workout when you’re lifting heavy objects. Other times when the pressure in your abdomen builds up and may make a hernia more noticeable include when you are coughing, sneezing, laughing or having a bowel movement.

Why is my groin lump painful?

Groin lumps may be painful for different reasons depending on the cause. Groin lumps caused by an infection may be painful because of your immune system responding to the infection.One of the associated symptoms is pain in order to alert you that something is wrong. If your groin lump is due to injury or muscle strain, damage to the muscles from trauma often leads to pain but should go away with rest and at-home treatments like over-the-counter painkillers.

What should I do if my groin lump is extremely painful?

Groin lumps caused by hernias can become severely painful if the tissue or intestine that has bulged through the weak spot in your abdomen becomes trapped outside and starts to lose its blood flow. If you notice severe, sudden, or worsening pain with your hernia, seek immediate medical attention, especially if you also have nausea, vomiting, or become unable to pass gas or have a bowel movement.

Do ingrown hairs cause groin lumps?

Ingrown hairs can cause groin lumps, especially if they become infected. The areas where each of your hair strands grow out of your skin are called follicles. When a follicle gets infected, usually due to a bacterial or fungal cause, it can lead to an area of red, painful, swollen skin and a collection of pus in the region, called folliculitis. When an infection in the hair follicles spreads deeper, this can lead to boils or clusters of boils (called carbuncles). A medical professional may recommend antibacterial ointments for infected follicles and warm compresses and/or oral antibiotics for carbuncles and boils.

Questions your doctor may ask about painful lump in one side of the groin

• What color is the bump?
• Any fever today or during the last week?
• Did anyone in your family have a hernia?
• Do you have a history of constipation?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Jeffrey M. Rothschild, MD, MPH.

Associate Professor of Medicine, Brigham and Women’s Hospital

Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP…

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Treatment, Causes, Prevention, and More

Vaginal boils are pus-filled, inflamed bumps that form under the skin of your vaginal area. They can occur due to impacted or infected hair follicles but may have other causes too.

All types of unusual bumps and spots can develop in the area around the vagina. The moist environment invites bacteria, and the hair follicles are ripe for in-grown hairs or inflammation.

A boil in the vaginal area can be especially painful. These pus-filled bumps are benign and rarely serious, but they can grow quite large. What starts out looking like a pimple can develop into a painful and irritating bump in a matter of days.

Read on to learn more about what causes vaginal area boils, what they look like, and how to treat and prevent them.

Vaginal area boils are pus-filled, inflamed bumps that form under the skin of your vaginal area. These bumps can develop on the outside of the vagina, in the pubic area, in the skin folds of the groin, or on the labia.

They’re often caused by impacted and infected hair follicles, but there can be other causes, too.

Boils around the vagina may be confused for herpes. Both types of bumps can look like pimples at first, and both may have a yellow discharge. But herpes sores typically remain small and develop in clusters, unlike boils.

Vaginal area boils are rarely a cause for concern. Most will clear up on their own in a couple of weeks. A few may need medical treatment. Treatment can help ease the pain and clear up the infection.

In severe cases, your doctor may lance, or cut, a boil to drain the infection.

If you have a spot on your vaginal area and aren’t sure if it’s a boil or the result of something else, such as a sexually transmitted infection, make an appointment to see your doctor or gynecologist.

A boil in the vaginal area often starts as a small red bump. It can resemble a pimple at first, but it may develop into a swollen, painful sore with a pus-filled white or yellow tip in a matter of days.

Boils may remain small, but some can grow to the size of a walnut.

Share on PinterestBoils are painful infections that occur around a hair follicle. This skin infection commonly occurs in the vaginal area.
Photography by DermNet New ZealandShare on PinterestBoils are common infections that occur around a hair follicle. Antoksena/Getty Images

In most cases, a vaginal area boil develops when a hair follicle becomes impacted and an infection develops. This is known as folliculitis.

These boils can have other causes, too, such as:

• A staph infection. Staphylococcus aureus (also known as staph) naturally lives on the outside of your body and in the opening of your nose. If the bacterium makes its way into the roots of the hair (the hair follicles), an infection can develop.
• A cut in the skin. Staph and other bacteria can get through the skin around the vagina from minor cuts that occur while you’re shaving or from an injury. Once bacteria enter the body, they can develop into an infection.
• Irritation. Friction from tight clothes can cause small tears and make skin around the vagina more susceptible to infections. Also, some people may have skin folds that rub and cause friction and irritation.
• Ingrown hairs. Ingrown hairs won’t always develop into boils, but if the hair follicle develops an infection, it can grow large and pus-filled.
• Close contact. If you’ve been in contact with someone who has a boil, shared clothes, or reused a towel, you may be more likely to develop a boil.
• Insect bites. Like cuts from razors, insect bites or other injuries can open the skin up to bacteria.
• Blocked Bartholin’s gland cysts. Bartholin’s glands are pea-sized glands near the opening of the vagina. If these glands become blocked, they can develop into cysts, and the cysts could become infected. This infection can lead to vaginal boils.

Having one boil doesn’t make you more likely to have another. However, some of the risk factors that lead to one boil can easily lead to another. These include:

• friction or rubbing from tight clothes
• ingrown hairs from shaving
• acne, eczema, or other skin conditions that damage your skin’s protective barrier
• being in close contact with someone who has a boil
• sharing personal items with someone who has a boil
• having a weakened immune system that’s less capable of fighting infection

Most boils will go away on their own in a few days or within a week or two. You can help ease the symptoms and speed up the process by taking the following steps:

• Apply a warm compress. Place a clean, warm, wet washcloth over the boil, and leave it there for 10 to 15 minutes. Repeat this process three or four times a day until the boil is gone. The heat from the compress helps promote more blood circulation, so white blood cells can fight off the remaining infection.
• Wear loose bottoms while it’s healing. Until the boil disappears, reduce friction in the area, and wear loose underwear and clothing. After workouts, change into clean, dry underwear.
• Clean and protect. If the boil bursts, clean the area thoroughly and apply an antibiotic ointment like combined bacitracin, neomycin, and polymyxin B (Neosporin). Then, cover with a sterile gauze or adhesive bandage. Keep the area clean, and change the dressing daily.
• Don’t pop or prick. Avoid picking or piercing the boil. Opening the boil releases the bacteria and can spread the infection. You may also make the pain and tenderness worse.
• Take over-the-counter (OTC) painkillers. OTC pain medication may be necessary to ease the pain and inflammation the boil causes. Take ibuprofen (Advil) or acetaminophen (Tylenol) according to the package directions.
• Wash your hands. Before you touch the boil or surrounding area, wash your hands with antibacterial soap and warm water. This will help keep you from introducing new bacteria to the boil. Wash your hands after you’ve touched the boil, too, to prevent spreading the infection to other areas of your body.

If these home remedies don’t help or the boil doesn’t clear up within 3 weeks, make an appointment with your gynecologist or doctor.

A boil typically clears up on its own in one to three weeks. Some boils will shrink and disappear. Others may burst and drain first.

If the boil grows significantly or is very painful, or if it doesn’t heal within 3 weeks, make an appointment with your doctor. They’ll examine the boil to determine if an antibiotic is necessary, or if lancing and draining the boil is required.

Most boils will remain small and can be treated at home. But if the infection grows larger, begins to spread, or shows signs of worsening, you may need medical treatment from a doctor.

The following symptoms may be a sign that the infection is worsening:

• fever
• chills or cold sweats
• a bump that grows rapidly
• a bump that’s extremely painful
• a bump that’s larger than 2 inches wide
• a boil that doesn’t clear up after 3 weeks

If more boils develop, or you notice a a cluster of boils, it’s also important to talk with your doctor. An underlying factor may be contributing to the boils. Treating the root cause can help prevent future boils.

Your doctor has two primary treatment options if the boil is too severe for home remedy treatments:

• Lance and drain. If the boil is extremely painful or large, your doctor may lance or cut the bump to drain the pus and fluid. Boils that have a severe infection may need to be drained more than once. Your doctor will use sterile equipment, so don’t attempt to do this at home.
• Antibiotics. Severe or recurrent infections may need antibiotics to prevent future boils. Your doctor may also prescribe antibiotics after the boil is drained to prevent secondary infection.

Preventing boils isn’t always possible, but these tips may help reduce your risk of future vaginal boils:

• Trim your pubic area. Trimming your pubic area with sharp, clean scissors rather than shaving minimizes any risk of ingrown hairs.
• Change your razor frequently. If you choose to shave, a dull razor can increase your risk of ingrown hairs. Change razors or blades every 3 to 4 weeks.
• Don’t share personal items. The bacteria responsible for a boil is easily transmitted if you share razors, towels, wash cloths, and other personal items. Keep these items stored away and don’t share them with other people.
• Shave in the shower or bath. Don’t dry shave your pubic area. Use a shaving lotion or cream to add extra moisture to your skin and to reduce friction.
• Shave in the direction of hair growth. Shaving in the direction your hair is growing can help reduce the likelihood of an ingrown hair.
• Gently exfoliate. By gently exfoliating the area around your vagina, you can remove dead skin cells and reduce the risk of ingrown hairs.
• Take all antibiotics. If your doctor prescribes oral antibiotics to treat your infection, complete the entire prescription, even if the boil starts improving. Stopping before you’ve taken the full course of antibiotics may lead to reinfection.
• Treat for staph. Staphylococcus aureus is a bacterium commonly found on the skin, and it can cause recurring boils, as well as other infections. If this bacterium is responsible, your doctor can specifically treat for it.
• Wash your hands. Before and after you touch your genitals, wash your hands with an antibacterial soap. This can help stop the spread of infection-causing bacteria.

Most vaginal area boils will shrink and disappear within a couple of weeks and will respond to at-home treatments.

Some boils, however, don’t respond to self-care treatments. If you notice that a vaginal boil hasn’t improved, is getting worse, or shows signs of infection, it’s important to seek medical attention.

Larger, more severe vaginal boils, or those that have become infected, will likely need to be lanced and drained, and possibly treated with antibiotics.

Inguinal purulent funiculitis. Review of clinical observations

The term funiculitis refers to inflammation of the membranes, fiber and elements of the spermatic cord (vas deferens, blood and lymphatic vessels, nerves) caused by banal or specific microflora [1, 2]. Currently, this term has become broader and includes many acute and chronic inflammatory diseases of the spermatic cord of various (autoimmune, infectious, pseudotumor and parasitic) nature, differing in clinical manifestations, course and prognosis [3, 4]. Funiculitis is often combined with inflammation of the vas deferens (deferentitis) and may be its complication (or vice versa), which confuses the terminology of these diseases [2].

BRIEF REVIEW. RELEVANCE

Inguinal purulent funiculitis (PGF) is a rare, insufficiently studied and unfamiliar disease for a wide range of surgeons, urologists and radiologists. This pathology was first described by N.R. Smith in 1834 as inguinal phlegmon of unclear etiology [2]. According to K. Eddy et al., in the English-language literature for the period from 1933 to 2011. only 4 cases of PHF are described [5, 6]. In total, 12 cases of PHF have been reported in the literature in patients of different ages, predominantly middle-aged and elderly [2-11].

The etiopathogenesis of PHF remains unexplored. PHF is considered as a phlegmon or abscess of the spermatic cord [2, 7], as a segmental infected dilatation of the inguinal part of the vas deferens [8], as a purulent vasitis (resp. , deferentitis) [3-6, 9-11]. It is assumed that PHF is caused by aerobic and anaerobic pyogenic flora, Mycobacterium tuberculosis, Pfeiffer’s Haemophilus influenzae, fungi. In most cases, the causative microflora and the source of infection at the time of clinical manifestation of PHF cannot be identified, which is considered as one of the features of this disease [11]. In this regard, it has even been proposed to refer to the disease as idiopathic PHF [2]. It is believed that the way the infection spreads to the membranes of the spermatic cord is hematogenous [2-6].

PHF affects the inguinal part of the spermatic cord [2-11]. PHF occurs in two clinical and pathomorphological forms (in the form of phlegmon and abscess of the spermatic cord), proceeds as an acute surgical disease and can be the cause of diagnostic errors, simulating a strangulated inguinal hernia, an abscess of the anterior abdominal wall, or an acute disease of the scrotum [3-6, 10 , eleven].

In the diagnosis of PHF, many authors noted the high efficiency of computed tomography (CT), which, in the literature observations presented, made it possible to identify phlegmon or abscess of the spermatic cord before surgery and exclude other acute surgical diseases, in particular, strangulated inguinal hernia [5, 6, 8- 14].

Treatment of PHF is only surgical (by percutaneous puncture and aspiration of the abscess of the spermatic cord under ultrasound navigation or by open surgery – revision and drainage of the membranes of the spermatic cord – with its phlegmon) [8-10]. With timely surgical treatment, the prognosis of the disease is favorable. A lethal outcome due to sepsis was observed in 3 (25%) of the described cases of PHF [2].

The prognosis for PHF may be different and depends on the clinical and pathomorphological form of the disease, the timeliness of diagnosis and treatment, as well as the immunoreactivity of the organism. In immunocompromised patients, PHF is characterized by a septic course and leads to death [2, 5, 6]. In patients of reproductive age, the course of PHF may be complicated by an excretory form of infertility due to the development of stricture or obliteration of the vas deferens as a result of inflammation [1, 2].

Over a 20-year period (from 1994 to 2014), two cases were observed in the City Clinical Urological Hospital No. 47 and the City Clinical Hospital No. 57 of the Moscow Healthcare Department, working in the emergency urological care mode. PHF, which caused serious diagnostic difficulties. We present these observations as an illustration.

CLINICAL CASE No. 1

Patient K., 42 years old in September 2009, was admitted to the clinic for urgent indications with a referral diagnosis: acute left-sided epididymo-orchitis, hydrocele on the left. Complains of enlargement and soreness of the left inguinal region and the left half of the scrotum, hyperthermia up to 38° C with chills for 1.5 weeks, weakness, sweating. I fell seriously ill. The disease is associated with hypothermia. In history, he suffered repeated urogenital infections (gonorrhea, trichomoniasis), in childhood – an orchiectomy on the right side due to inguinal cryptorchidism, which led to testicular atrophy. Tuberculosis, HIV, hepatitis B and C denies. The general condition of moderate severity, due to inflammatory intoxication. Body temperature – 37.5 ° C. Correct physique, normal nutrition. The skin is pale with an earthy tint. No pathological abnormalities were found in the internal organs and organ systems. BP – 130/70 mm. rt. Art., pulse – 92 bpm On examination, there was an increase in the left inguinal region and the left half of the scrotum. The skin of the left inguinal region is hyperemic, edematous, the local temperature is elevated. In the projection of the left inguinal canal, an ovoid-shaped taut-elastic and sharply painful formation 7×3 cm is palpated, limited by the anatomical boundaries of the inguinal canal. The color of the skin of the scrotum and the local temperature are not changed, the folds of the skin of the left half of the scrotum are somewhat smoothed. The left testicle, epididymis and scrotal part of the spermatic cord were not changed on palpation. There is a slight accumulation of fluid in the membranes of the left testicle (hydrocele). The right testicle in the scrotum is not defined (removed). No pathological discharge from the urethra was noted. On digital rectal examination, the rectum, prostate gland, seminal vesicles and ampullar sections of the vas deferens were not changed. Blood tests revealed moderate anemia (hemoglobin – 108 g/l, erythrocytes – 4.0×106), leukocytosis up to 16×103, a shift in the blood formula to the left to young forms, an increase in ESR to 43 mm/hour. No pathological changes were found in urine tests. Chest x-ray showed no focal infiltrative changes in the lungs, diffuse enhancement and deformity of the lung pattern (chronic bronchitis “smoker”). Ultrasound examination (ultrasound) in the projection of the left inguinal canal revealed a liquid heterogeneous formation of a “cigar-shaped” shape 9, 5×3.5×4.2 cm (280 cm3), completely occupying the inguinal canal and limited by its walls, pushing back the elements of the spermatic cord (Fig. 1, 2, 3, 4). Magnetic resonance imaging (MRI) was performed, which confirmed the ultrasound data and additionally revealed a high protein content in the effusion of the left inguinal canal, which indicated its purulent nature (Fig. 5, 6). Differential diagnosis was carried out between a festering cyst (as the most likely diagnosis) and a hematoma (as the least likely diagnosis) of the spermatic cord. An exploratory revision of the inguinal canal confirmed the presence of a purulent cystic formation of the spermatic cord, which was opened, excised and drained. About 250 ml of thick pus was evacuated, the walls of the inguinal canal and the membranes of the spermatic cord were saturated with pus, thickened and compacted. During the operation, a possible suppuration of a congenital funiculocele was suggested. Histopathological examination revealed a pattern of diffuse purulent inflammation of the membranes and fiber of the spermatic cord. When sowing purulent contents, the growth of the flora was not detected. The outcome of the disease is recovery.

Fig. 1. Case No. 1. Patient K., 42 years old. Panoramic longitudinal echogram of the left inguinal-scrotal region. 1 funiculopiocele occupying the entire inguinal canal, 2 – unchanged testicle and epididymis, 3 – small hydrocele

2. The same patient. Targeted ultrasound of the left inguinal region. 1 – funiculopiocele, 2 – unchanged funicular part of the vas deferens

3. The same patient. Transverse echogram of the inguinal canal on the left in the middle third. 1 – funiculopiocele, 2 elements of altered spermatic cord

Fig. 4. The same patient. Doppler angiogram of the spermatic cord on the left in the middle third of the inguinal canal. 1 – funiculopiocele, 2 – vessels of the spermatic cord

5. The same patient. MRI. Front cut. A – T1VI, B – T2VI. 1 – funiculopiocele on the left, 2 – hydrocele on the left, 3 – right testicle is absent in the scrotum (removed)

6. The same patient. MRI. T2VI. Axial section at the level of the middle third of the inguinal canal on the left. 1 – funiculopiocele, 2 – spermatic cord

CASE STUDY No. 2

Patient S., 63 years old, in August 2010, due to prostate cancer Т1N0M0 underwent radical prostatectomy. The early postoperative period was complicated by a festering pelvic lymphocele with a volume of 650 ml, which was drained by an open method. Wound healing by secondary intention. He was discharged on the 24th day after the operation in a satisfactory condition. 1 month after discharge, he was admitted to the clinic again with complaints of enlargement and soreness of the left inguinal region and the left half of the scrotum, hyperthermia up to 38° with chills for 5 days. The general condition of moderate severity, due to purulent-inflammatory intoxication. In the left inguinal region, a motionless, rigid, and sharply painful formation 10x4x3 cm is palpated, the skin above it is edematous and hyperemic (Fig. 7). Acute epididymo-orchitis and strangulated inguinal hernia were excluded during clinical and echographic examination. The suggestion of an inguinal lymphocele was also rejected, since no dissection of the inguinal lymph nodes was performed during the previous operation. Ultrasound of the inguinal canal on the left revealed an encysted accumulation of heterogeneous fluid in the membranes of the spermatic cord (Fig. 8). Preliminary diagnosis: acute inguinal funiculitis with the development of reactive (inflammatory) funiculopiocele. During the revision of the inguinal canal and spermatic cord, about 150 ml of intershell purulent exudate was evacuated, thickening and thickening of the walls of the inguinal canal and membranes of the spermatic cord was noted. Histopathological examination of the resected membranes of the spermatic cord revealed signs of acute purulent diffuse inflammation (Fig. 9). When sowing the contents of the membranes of the spermatic cord, the growth of the flora was not detected. The outcome of the disease is recovery. The patient was discharged on the 20th day after the operation in a satisfactory condition with a healed wound. Ultrasound examination 2 weeks after the operation showed restoration of the structure of the spermatic cord and the walls of the inguinal canal (Fig. 10).

Fig. 7. Case No. 2. Patient S., 61 years old. Asymmetric enlargement of the right groin and scrotum (arrow). Hyperemia of the skin of the scrotum and inguinal region on the right. Right-sided inguinal funiculitis

Fig. 8. The same patient. Panoramic longitudinal echogram of the right inguinal-scrotal area. 1 funiculopiocele simulating an inguinal hernia, 2 intact testis and epididymis, 3 hydrocele, 4 abdominal cavity

9. The same patient. Micropreparation of the membranes of the spermatic cord. Hematoxylin and eosin. Magnification: x 100. Foci of polymorphonuclear leukocyte and eosinophilic infiltration (1) with hemorrhage foci (2). Acute purulent funiculitis

Fig. 10. The same patient. 14th day after the operation – opening and drainage of the phlegmon of the spermatic cord on the right. Panoramic longitudinal echogram of the right inguinal-scrotal area. Restoration of the structure of the spermatic cord and inguinal canal. 1 – spermatic cord, 2 – testis, 3 – hydrocele, 4 – abdominal cavity

DISCUSSION

The clinical manifestations and course of PHF in our observations did not differ from the cases of PHF described in the literature [2–11]. PHF clinically simulated various acute diseases of the inguinal-scrotal region: from acute purulent epididymo-orchitis to festering hematoma of the spermatic cord. The final verification of the disease belonged to intraoperative and pathomorphological research methods.

The etiopathogenesis of PHF in the presented two cases remains unclear. In the 1st case, given the history of anomalies of the genital organs (cryptorchidism), repeated urogenital infections and the results of an exploratory revision of the inguinal canal, suppuration of a congenital funiculocele against the background of a latent infectious deferentitis can be assumed as a pathomorphological substrate for PHF. As is known, congenital incomplete obliteration of the vaginal process of the peritoneum (processus vaginalis peritoneae Halleri) occurs in approximately 20% of children and can cause the development of funiculocele complicated by suppuration [12].

In the 2nd case, the occurrence of PHF was more likely to be preceded by pelvic purulent cellulitis and pelvic pyolymphocele, which arose as a complication of radical prostatectomy. It is known that complications of radical prostatectomy are not uncommon: in every 4th – 5th patient [13]. Among them, purulent-inflammatory diseases of the kidneys, urinary tract, scrotum organs and pelvic tissue occupy the first place, accounting for 40–60% of all postoperative complications [13, 14]. At the same time, the most probable pathway for the spread of a purulent infection from the bed of the removed prostate gland to the membranes of the spermatic cord is well studied: along the fascial case of the vas deferens to the membranes of the spermatic cord along the continuation – per continuitatem with the formation of a funicolopyelocele [15].

Our observations showed a high diagnostic efficiency of high-resolution ultrasound (6-16 MHz) and MRI. Ultrasound played the main role, it made it possible to assess the nature of the volumetric lesion of the spermatic cord and to conduct a differential diagnosis with acute surgical diseases of the inguinal-scrotal region. MRI, in our opinion, is somewhat more accurate than ultrasound in assessing the prevalence of lesions of the spermatic cord, as well as in clarifying the nature of the effusion (pus, blood, lymph).

Treatment of PHF was surgical: revision of the inguinal canal, excision and drainage of the funiculopiocele. Surgical intervention was performed according to urgent indications for diagnostic and therapeutic purposes and in compliance with the principles of purulent surgery; Both patients recovered as a result of treatment.

PHF is proposed to be differentiated primarily from strangulated inguinal hernia and acute diseases of the scrotum (acute epididymitis and testicular torsion), as well as from hematoma, vein thrombosis and tumor of the spermatic cord, osteomyelitis of the pubic bones and symphysis [2-11]. In the differential diagnosis of PHF and acute diseases of the scrotum, the method of choice is gray scale ultrasound, supplemented by Doppler sonography; while when distinguishing between PHF and strangulated inguinal hernia, priority belongs to computed tomography (CT) [5, 6, 8]. For the diagnosis of a tumor or hematoma of the spermatic cord, the use of MRI and high-resolution ultrasound is effective, for osteomyelitis of the pelvic bones, the use of pelvic radiography and CT [2, 5, 6]. In our observations, the use of a complex radiation examination, including high-resolution ultrasound (6-16 MHz) and MRI of the inguinal-scrotal region, made it possible to speak about the nature of the disease of the spermatic cord and choose the necessary treatment tactics.

CONCLUSION

Inguinal purulent funiculitis is an extremely rare disease with unknown etiopathogenesis. One of the likely mechanisms for the development of PHF is the suppuration of a congenital funiculocele or the development of an acquired funiculopiocele on the background of a urogenital infection or pelvic purulent cellulitis. A causative infection, presumably from the urethra, prostate, seminal vesicles and pelvic tissue, spreads to the membranes of the spermatic cord along the lumen of the vas deferens (canalicular way) or along its fascial sheath and further – from the vas deferens to the spermatic cord – along the continuation (per continuitatem) . PHF occurs as an acute surgical or urological disease and causes serious diagnostic difficulties. In the diagnosis of PHF, the use of high-resolution ultrasound and MRI of the inguinal canal and scrotum is effective. The final verification of the diagnosis is carried out by intraoperative and pathomorphological methods. PHF must be differentiated using radiation methods with acute diseases of the inguinal region, and above all, with strangulated inguinal hernia, acute epididymitis and testicular volvulus. Treatment of PHF should be surgical (revision of the inguinal canal, opening and drainage of the membranes of the spermatic cord). With timely diagnosis and treatment, the prognosis of PHF is favorable.

LITERATURE

1. Tiktinsky O.L., Mikhailichenko V.V. Andrology (manual). SPb., 1999, pp. 62 – 80.

2. Wilensky AO, Samuels SS. Acute deferentitis and funiculitis.// Ann Surg. 1923 Vol. 78, No. 6. P. 785–794.

3. Bissada NK, Redman JF. Unusual masses in the spermatic cord: report of six cases and review of the literature. // South Med J. 1976. Vol. 69. P. 1410–1412.

4. Chan PTK, Schglegel PN. Inflammatory conditions of the male excurrent ductal system. review. Part II. // J Androl. 2002 Vol. 23, No. 4. P. 461 – 469.

5. Eddy K, Pierce B, Eddy R. Vasitis: clinical and ultrasound confusion with inguinal hernia clarified by computed tomography. // Can Urol Assoc J. 2011. Vol. 5, N 4. P. E74 – E76.

6. Eddy K, Connell D, Gooodacre B, Eddy R. Imaging findings prevent unnecessary surgery in vasitis: an under-reported condition mimicking inguinal hernia. // Clin Radiol. 2011 Vol. 66, No. 5. P. 475 – 477. 7. Maitra AK. Odd inguinal swelling. // Lancet. 1970 Vol. 1. P. 45.

8. Gomez Herrera JJ., Zabia Galindez E, Carrera Terron R, Borruel Nacenta S. Dilatacion unilateral completa de conducto deferente como causa de massa inguinal. // Radiology. 2013. Vol. 55, No. 6. P. 533 – 536.

9. Bissada NK, Redman JF, Finkbeiner AE. Unusual inguinal mass secondary to vasitis. // Urology. 1976 Vol. 8. P. 488 – 499. 10. Ryan S.P, Harte PJ. Suppurative inflammation of vas deferens: an unusual groin mass. // Urology. 1988 Vol. 31. P. 245 – 246.

11. Wolbarst AL. The vas deferens, generally unrecognized clinical entity in urogenital disease. // J Urol. 1933 Vol. 29. P. 405 – 412.

12. Garriga V, Serrano A, Marin A, Medrano S, Roson N, Pruna X. US of the tunica vaginalis testis: anatomic relationships and pathologic conditions. //RadioGraphics. 2009. Vol. 29. P. 2017 – 2032.

13. . Froehner M, Novotny V, Koch R, Leike S, Twelker L, Wirth MP. Perioperative complications after radical prostatectomy: open versus robot-assisted laparoscopic approach. // Urol. Int. 2013. Vol. 90, N 3. P. 312 – 315.

14. Salomon L, Levrel O, Anastasiadis AG, Saint F, de La Taille A, Cicco A, Vordos D, Hoznek A, Chopin D, Abbou CC. Outcome and complications of radical prostatectomy in patients with PSA 10 ng/ml: comparison between the retropubic, perineal and laparoscopic approach. // Prostate Cancer Prostatic Dis. 2002 Vol. 5, No. 4. P. 285 – 290.

15. Kovanov V.V., Anikina T.I. Surgical anatomy of fasciae and cellular spaces in humans. Moscow: Medgiz, 1961. P. 169 – 185 394.91 kb

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causes, treatment and surgery? – Drink-Drink

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Jun 09, 2023

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10.02.2022 DrinkDrinkAdmin

Contents

• What is an inguinal abscess?
• causes
• symptoms
• diagnostic
• Who and when to consult?
• Treatment: how to treat?
• Operation and drainage: in what cases?
• What if an abscess bursts on its own?

A lump that develops in the groin may be an abscess. This can cause pain and discomfort. Treatment varies depending on whether the puncture occurs naturally or not. Explanations and recommendations for care. Explanations with Dr. Philippe Goeb, General Practitioner.

What is an inguinal abscess?

An inguinal abscess develops in the groin, the part of the body located between the thigh and the trunk. “ Like any abscess, it is a collection of pus in the dermis (hair root, sweat gland, sebaceous gland), which in the course of its evolution gradually destroys the tissues surrounding it, explains Dr. Philippe Goeb, general practitioner. Inguinal abscess is caused by localized infection and has symptoms of inflammation. Depending on the type of inguinal abscess and especially its location, treatment may include antibiotics or surgical treatment of the inguinal abscess. “.

causes

One poorly treated wound, mosquito pimple, scratched by hands and especially dirty nails , and the infection progresses to the point of an abscess, forming a focus of yellowish, painful, pulsating pus.

symptoms

If the inguinal abscess is located superficially, it appears a bump of variable size, painful to the touch, also called a tumor. If it is deep, palpation increases pain near its location. Then the most common symptoms are as follows:

• localized pain
• Hot, red skin
• swelling of the skin
• Presence of pus within an abscess due to accumulation of microbes
• Sometimes fever

diagnostic

Often history and clinical examination are sufficient. for the diagnosis of inguinal abscess. To determine the size or level of infection, the doctor may, if in doubt, ask:

• Ultrasound often, MRI, or scanner (rarely needed for superficial inguinal abscesses;
• puncture to take a sample;
• blood test.

Scheduled examinations also have the function of providing medical information necessary for possible surgery.

Who and when to consult?

In case of pain, or if the abscess does not disappear despite treatment (wash the wound with soap, then apply antiseptic compresses), see a doctor, dermatologist, or even the emergency room for minor surgery.

Treatment: how to treat?

“Yes the abscess is opened it is necessary that consult a doctor to avoid infection complications which can become even more serious because the femoral artery passes nearby, warns Dr. Geb. Your doctor will drain this abscess to thoroughly clean and disinfect it. He may prescribe an antibiotic. “. Antibiotics are not necessary unless there are signs of infection. 85% of abscesses heal without antibiotic therapy. Systematic antibiotic therapy increases this cure rate to about 92% with less frequent relapses. “ But the rate of cure without antibiotics and the risk of antibiotic resistance justify not immediately prescribing an antibiotic to all patients. , says our expert.

Operation and drainage: in what cases?

Si the abscess does not open , it is recommended to evacuate the pus thanks to a surgical gesture that remains limited. It is done most often under local anesthesia, through an evacuation puncture, incision or surgery. To avoid recurrence, a doctor or surgeon will sometimes place a drain or absorbent wick that will evacuate any remaining pus. The wick should be changed every 48 hours by a doctor or nurse. Medical treatment completes intervention : this includes analgesics to control pain and fever, and antibiotics to control infection. If you experience pain, a feeling of heat, swelling, or a temperature rise above 38 °, tell the nurse or doctor who monitors the course of treatment.

What if the abscess ruptured on its own?

Consult your physician to avoid taking unnecessary risks given the location of this abscess. In anticipation of an urgent consultation, clean around the abscess and apply a compress moistened with an antiseptic.