Greetings Dr. Goldstein,

First and foremost Shabbat Shalom :)  My name is Russ.  Back in November I became intimately active with a woman that I am now in a relationship with.  After that particular occasion I developed what my doctor diagnosed as sclerosing lymphangitis.  Basically I had an enlarged, cord-like vessl just below my head . There was no pain or swelling but it was noticeably larger.  Anyway, I abstained from sexual activity and manual stimulation, and after 8 weeks it finally went back to normal, actually some gentle sexual activity the last few weeks seemed to help it.  

This region was prone to slight swelling in the past, but it always went away rather quickly.  In any case, since it healed i have been taking it easy in the sexual department, but I also find that i am afraid and overly careful..to the point where im almost obsessive about it because i dont want to have another 8 week flare up.  I was hoping you could offer some input on this and make some suggestions on how to prevent this from happening again in the future.  I appreciate your time and look forward to your response.

Kind Regards,


Russ, what you are describing probably represents a thrombosis (clot) of a penile lymphatic vessel.   This is also called sclerosing lymphangitis.  Lymphatics are tissue vessels that are present all over the body connecting lymph nodes.  It is a distinctly separate system from blood vessels (arteries and veins).  Rather than blood, they carry an opaque fluid called lymph.   Their function is to keep the tissues healthy by filtering out harmful substances (such as bacteria, viruses, tumor cells, etc.) and enhancing immunity.  Sometimes during sexual activity, the lymphatics get bruised resulting in subsequent clot formation.   One notices a firm, often finely beaded vessel under the skin of the penis that is mildly tender.  This is not a dangerous condition and the clot resolves on its own in a few weeks unless there is recurrent trauma to the area.  Therefore, sexual activity should be curtailed until healing has occurred. When you have sex, use a good lubricant (such as one of the "silk" lubricants) and try to avoid excessive trauma to the penis.  This is not a serious condition; it does not predispose to other problems and is more of a nuisance than a disease.  Good luck.


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Arthur Goldstein, M.D.


Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.


I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

American Medical Association, American Urological Association, American College of Surgeons

College degree - BS Medical degree - MD Master of Science - MS

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