<s>[INST] Over the past two weeks, I have felt a lump under the skin between my scrotum and anus, slightly towards the right side.  Painless, and not visible, I only know its there when I exert slight pressure.  Bean-shaped I guess.  49 Year old male.  I also find I am constantly tired, listless, completely without energy, total contrast to my normal self. [/INST] Hi, Dear,Thanks for the query to Chat Doctor. I studied your problem in depth and I understood your concerns. Treatment-In my opinion your perineal lump for 2 was has caused systemic effects of infection with in and has lead to listless life for you. I would Suggest you to consult ER surgeon- and to take antibiotics / anti-inflammatory with hot fomentation locally or/ infra-red locally for the early recovery of the bean sized perineal lump. Cause of it is mostly a folliculitis with boil formation with cellulitis and induration in it. Leave it to ER Surgeon who would treat it accordingly for that lump. If it grows in size consult ER Surgeon. So consult your doctor and don't worry. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to Chat Doctor and be comfortable to resolve your health issues. Welcome for any more query in this regard to Chat Doctor. Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. Chat Doctor. N. </s>