Scrotal pain syndrome

The scrotum is the loose pouch of skin that holds your testicles. Each testicle makes sperm and testosterone, which is the main male hormone. Your scrotum also protects your testicles, blood vessels, and nerves. It contains important tubes - called the epididymis and ductus deferens - that help store and move sperm.

Scrotal pain syndrome is long-lasting pain in one or both testicles that lasts for months. Some men feel a dull ache that comes and goes, while others may have constant or sharp pain. This kind of pain can be really worrying and can affect your day-to-day life. 

There are several conditions that can cause scrotal pain. However, in about half of men, doctors can't find a clear cause for the pain.  This can be frustrating - especially if you’ve seen different doctors and still don’t have clear answers. If this sounds familiar, it might help to see a urologist (a doctor who specialises in urinary and male reproductive health).

When no clear cause is found, the pain is called scrotal pain syndrome.

Scrotal pain can also happen after:

• An injury to the area (trauma).
• A vasectomy (in which the tubes that carry sperm from the testicles are cut or blocked).
• Hernia repair surgery

Up to 20% of men who have had a vasectomy and 10% who have had a hernia repair experience scrotal pain in the months after surgery.

If you have scrotal pain syndrome you may have one or more of the following:

• Ongoing pain in one or both testicles for at least 3 months.
• Pain in your groin when you move or are physically active.
• A feeling of heaviness or sensitivity in your scrotum.
• Sudden, sharp pain in your testicle without warning.
• Needing to pee more often than usual.
• Blood in your urine or semen.

Pain and quality of life assessment
Your doctor may ask you to fill out a questionnaire to better understand how the pain affects your life. They may also ask questions about pain during or after sex, and how you're feeling mentally. These can be sensitive topics, but being open helps your doctor find the right support and treatment for you.

Physical examination
Your doctor will talk with you about your symptoms and check your testicles. This means they’ll gently press on the area to check for tenderness, swelling, or any lumps. They may also check your lower tummy, pelvis, and groin. This can feel embarrassing, but these checks are quick and important for ruling out other problems.

Ultrasound
An ultrasound uses sound waves to create pictures of the inside of your scrotum. This test helps your doctor check the testicles and surrounding area to rule out possible causes of your pain. It’s a simple and painless procedure.

There isn’t one single treatment that works for everyone with scrotal pain syndrome, but there are a number of things you can try to manage your symptoms. It may take time to find the right combination that works best for you.

This chapter contains general information about scrotal pain syndrome. It is not a substitute for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.

Last updated: April 2025