Pain affecting the male reproductive area can be concerning and uncomfortable. Male genital pain may affect the testicles, scrotum or groin. The sensation may vary from mild discomfort to severe pain that interferes with daily activities.
Male Genital Pain: Causes, Symptoms and Treatment
In many cases, testicular pain is temporary and may resolve on its own. However, persistent symptoms or sudden severe pain may indicate an underlying medical condition that requires evaluation. Because the reproductive organs contain sensitive structures responsible for fertility and hormone production, proper assessment is important when symptoms occur.
Men who experience scrotal pain may notice discomfort during physical activity, standing for long periods or after exercise. Although some causes are relatively minor, other conditions may require medical treatment. Understanding the potential causes and recognising when medical evaluation is needed can help guide appropriate care.
What is Male Genital Pain
Male genital pain refers to discomfort affecting the scrotum, testicles, penis or surrounding groin region. The pain may originate from the reproductive organs themselves or from nearby structures such as muscles, nerves or blood vessels.
In many cases, the discomfort is described as scrotal pain, which may involve the entire scrotal sac or only one testicle. The sensation may range from mild pressure to persistent aching that worsens during movement or prolonged standing.
Some men experience testicular pain that occurs intermittently and improves with rest. Others may notice discomfort that persists throughout the day or becomes more noticeable during physical activity. Because several conditions can produce similar symptoms, evaluation by our urologist is often necessary to determine the underlying cause.
Common Symptoms of Male Genital Pain
Symptoms associated with male genital pain can vary depending on the underlying condition. Some men experience mild symptoms that appear gradually, while others develop sudden discomfort that requires urgent medical attention.
Common symptoms may include:
- Dull pain in the testicle that gradually worsens throughout the day
- Sharp or sudden scrotal discomfort that appears unexpectedly
- Scrotal heaviness or pain in the testicle when standing or walking for extended periods
- Visible testicular swelling accompanied by pain
- Testicle pain after exercise
- Pain experienced during ejaculation or sexual activity
In some cases, men may describe chronic testicular pain that does not improve with rest. Others may notice an aching testicle that becomes more noticeable after prolonged activity.
Common Causes of Testicular or Scrotal Pain
Several medical conditions can cause male genital pain. Identifying the underlying cause is important because treatment may vary depending on the condition responsible for the symptoms.
Varicocele
Varicocele is a condition in which veins within the scrotum become enlarged due to impaired blood flow. This may cause a feeling of heaviness or aching within the testicles.
Men with varicocele may experience varicocele testicular pain that develops gradually over time. The discomfort is often described as a dull pain in the testicle, particularly after standing for extended periods.
The pain associated with a varicocele may also be linked to pain in the testicle when standing, which improves when lying down or resting.
Epididymitis
Epididymitis occurs when the epididymis becomes inflamed, often due to infection. This structure is responsible for storing and transporting sperm from the testicles.
Inflammation of the epididymis can lead to scrotal pain that may worsen over several days. The condition may also cause testicular swelling and pain accompanied by redness or warmth in the scrotum.
In some cases, infection may produce fever or urinary symptoms alongside scrotal discomfort.
Testicular Torsion
Testicular torsion is a medical emergency that occurs when the spermatic cord twists, cutting off the blood supply to the testicle.
This condition typically causes sudden and severe testicular pain that appears without warning. The pain may also be associated with nausea, vomiting or abdominal discomfort.
Immediate medical treatment is required to prevent permanent damage to the testicle.
Hydrocele
A hydrocele refers to the accumulation of fluid around the testicle. This condition may lead to visible swelling in the scrotum.
Some individuals experience mild scrotal discomfort rather than severe pain. However, larger hydroceles may cause scrotal heaviness due to the increased weight within the scrotum.
Hydroceles are often painless but may become noticeable when swelling increases.
Hernia
An inguinal hernia occurs when tissue from the abdomen protrudes through a weak area in the abdominal wall. This can create a bulge in the groin that may extend into the scrotum.
Men with hernias may experience aching testicle sensations along with groin discomfort. The pain may worsen with lifting, coughing or physical activity.
In some situations, hernias may cause pain in the testicle when standing, particularly if pressure increases within the abdomen.
How Male Genital Pain is Evaluated
Evaluation of male genital pain usually begins with a clinical assessment and diagnostic testing. These investigations help identify the underlying cause and guide treatment decisions.
Physical examination
A physical examination is the first step in evaluating scrotal or testicular symptoms. During the assessment, our urologist examines the scrotum, testicles and surrounding groin area to identify tenderness, swelling or structural changes.
This helps detect conditions such as enlarged veins, fluid accumulation or areas of inflammation. The examination may also be performed while standing and lying down, as certain conditions become more noticeable in specific positions.
Ultrasound
Scrotal ultrasound is a non-invasive imaging test that provides detailed images of the testicles and surrounding structures. It allows our urologist to assess blood flow within the scrotal veins and identify abnormalities such as varicocele, hydrocele or inflammation of the epididymis.
Ultrasound is particularly useful when physical findings are unclear or when further confirmation of the diagnosis is required.
Urine testing
Urine testing helps detect infections or inflammation within the urinary or reproductive tract. A urine sample may be analysed for bacteria, white blood cells or other indicators of infection.
Identifying infection allows our urologist to determine whether urinary conditions may be contributing to scrotal pain and to recommend appropriate treatment.
Semen analysis
Semen analysis evaluates sperm count, movement and overall semen quality. This test may be recommended when testicular symptoms occur alongside fertility concerns.
The results help our urologist assess whether conditions affecting sperm production or testicular function may be contributing to symptoms and guide further management.
Treatment for Testicular Pain
Treatment for male genital pain depends on the underlying cause. Some conditions may respond to medication or supportive care, while others may require surgical intervention.
Non-Surgical Treatment and Supportive Care
Supportive care is often the first step in treatment, particularly when symptoms are mild or temporary. However, persistent symptoms such as chronic testicular pain or ongoing male genital pain may require further evaluation to determine whether targeted medical or surgical treatment is necessary.
- Rest and activity modification – Temporary rest and avoiding strenuous activity may help reduce symptoms, particularly in cases such as testicle pain after exercise or minor strain affecting the groin or scrotum.
- Scrotal support – Wearing supportive underwear or an athletic supporter may help relieve scrotal discomfort and reduce pressure on the testicles.
- Cold or warm compresses – Cold packs may reduce swelling and inflammation, while warm compresses can help ease muscle tension and improve comfort.
- Anti-inflammatory medication – Medications may be used to reduce inflammation and relieve scrotal pain or testicular pain caused by irritation or mild injury.
- Antibiotic therapy – When an infection, such as epididymitis, is present, antibiotics may be prescribed to treat the infection and reduce testicular swelling and pain.
Surgical Treatment
When symptoms persist or when imaging confirms an underlying problem, surgery may be recommended to address the specific cause of pain rather than only managing symptoms.
- Hernia repair surgery – Inguinal hernias occur when abdominal tissue protrudes through a weak area in the groin. This may lead to groin discomfort or pain radiating to the testicle, especially when standing, lifting, or straining. Surgical repair closes the defect in the abdominal wall and helps relieve pressure, which may be causing the pain.
- Hydrocelectomy – A hydrocele is a fluid collection surrounding the testicle that can cause scrotal swelling and discomfort. Hydrocelectomy removes or drains the fluid-filled sac, which can reduce pressure and restore a more normal scrotal contour.
- Microsurgical varicocelectomy – Varicocele occurs when enlarged veins develop within the scrotum, sometimes causing a dull aching sensation or scrotal heaviness. Microsurgical varicocelectomy seals the abnormal veins and redirects blood flow through healthier vessels, which may relieve symptoms and improve testicular function.
- Spermatic cord denervation – In selected cases of chronic testicular pain that does not respond to other treatments, microsurgical denervation of the spermatic cord may be considered. This procedure targets the nerve pathways responsible for persistent pain while preserving blood supply to the testicle.
Surgical treatment is recommended only after careful evaluation to determine the underlying cause of symptoms. Identifying the specific condition allows appropriate procedure to be selected to relieve pain and restore normal function.
Preventing Testicular Pain
Some causes of male genital pain may be prevented by reducing risk factors and maintaining reproductive health.
Preventive measures include:
- Avoiding trauma to the scrotal area during physical activity
- Practising safe sexual behaviours to reduce infection risk
- Seeking early medical care for persistent scrotal pain
- Monitoring symptoms that may indicate developing conditions
Early recognition of symptoms such as testicle pain after exercise may help identify underlying issues before they worsen.
When Should You See Our Urologist
Some cases of male genital pain may resolve on their own. However, certain symptoms require prompt medical attention.
Seek medical care if:
- Testicular pain is severe or sudden
- Pain persists for more than 48 hours
- Testicular swelling or pain develops without an obvious cause
- Fever or nausea occurs with scrotal symptoms
- Pain begins suddenly without an obvious cause
Sudden severe scrotal pain may indicate conditions such as testicular torsion that require immediate treatment.
Book a Consultation for Male Genital Pain
Men experiencing male genital pain may benefit from a professional evaluation. A consultation allows discussion of symptoms, possible causes and appropriate treatment options based on individual findings.
Assessment may include a physical examination, ultrasound imaging, urine testing or other diagnostic tests to identify conditions that may be contributing to symptoms. In some cases, Dr Lee Fang Jann may discuss treatment options for conditions such as varicocele, infection or other causes of chronic testicular pain.
Early evaluation helps identify underlying conditions that may be responsible for discomfort and allows appropriate treatment to be recommended before symptoms worsen.
Dr Lee Fang Jann 
Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders
He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).
- Bachelor of Medicine and Bachelor of Surgery (Singapore)
- Membership of The Royal College of Surgeons (Edin)
- Master of Medicine (Surgery) (Singapore)
- Fellowship of the Academy of Medicine (Urology)
- Clinical fellowship at Oxford Transplant Centre in the UK
Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.
Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.
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Frequently Asked Questions
What causes testicular pain?
Testicular pain can be caused by several conditions, including varicocele, infection such as epididymitis, hydrocele, hernia or injury to the scrotum.
Why does my testicle hurt when standing?
Some men experience pain in the testicle when standing due to increased pressure in the scrotal veins, especially in conditions such as varicocele.
Is testicular pain serious?
Not all testicular pain is serious, but sudden or severe symptoms may require medical evaluation to rule out urgent conditions.
Can a varicocele cause chronic testicular pain?
Yes, some individuals with varicocele may develop chronic testicular pain, particularly after prolonged standing or physical activity.
How is testicular pain treated?
Treatment for scrotal pain depends on the underlying cause and may involve medication, antibiotics or surgical procedures.