Version July 2025
| Location of pain | Characteristics of discomfort | Symptoms occur primarily with sexual activity | Urinary symptoms | |
| Ejaculatory pain | ||||
| Genitourinary infection | Primarily penile pain Pain in the urethra, testicles, rectum, or abdomen have also been reported | Pain occurs during or after ejaculation and usually subsides within minutes | Yes, with ejaculation | Yes |
| Urethral or ejaculatory duct obstruction | Yes, if obstructive uropathy is present | |||
| Postsurgical sequelae | No | |||
| Medication effect | No | |||
| Postorgasmic illness syndrome | Diffuse, flu-like symptoms and feelings of confusion following ejaculation | Yes, with orgasm | No | |
| Scrotal pain | ||||
| Epididymitis or epididymo-orchitis | Scrotum | Discomfort is constant Sexual activity exacerbates pain | No, discomfort is generalized | Yes, dysuria is possible |
| Varicocele | Scrotum | Dull pain, usually left-sided Worse with standing and improved with laying down | No, discomfort is generalized | No |
| Recent scrotal surgery | Scrotum | Varies | Varies | No |
| Referred pain from hernia | Varies | Discomfort worsens with lifting, straining, or prolonged standing | No, discomfort is generalized | No |
| Referred pain from hip injury | Unilateral hip pain | Movement of affected hip worsens pain | No, discomfort may occur with any activity | No |
| Penile anatomic abnormalities | ||||
| Peyronie's disease | Penis | Penile pain occurs primarily during erection | Yes | No |
| Phimosis | Penis | Discomfort is intermittent or constant Pain is worsened with erection | Varies | Yes, if obstruction or balanitis is present |
| Frenulum breve | Glans | Discomfort is intermittent or constant Pain is worsened with erection Onset is in early childhood or adolescence | Yes | No |
| Dermatologic conditions | ||||
| Lichen planus | Associated with location of skin condition | Discomfort is intermittent or constant Sexual activity exacerbates pain | Varies | No |
| Lichen sclerosis | Yes, if associated urethral stricture is present | |||
| Zoon's (plasma cell) balanitis | No | |||
| Balanitis/balaoposthitis | Yes, if meatal involvement | |||
| Penile carcinoma | Yes, in rare cases of urethral invasion or meatal involvement | |||
| Etiologies with generalized symptoms | ||||
| Chronic prostatitis/chronic pelvic pain syndrome | Varied, generalized pelvic pain and discomfort in other areas | Discomfort is intermittent or constant Sexual activity exacerbates pain | No | Yes, dysuria or urinary frequency and urgency |
| Pudendal nerve entrapment | Unilateral | Pain worse with sitting, along distribution of the pudendal nerve | No | |
| Interstitial cystitis (painful bladder syndrome) | Bladder discomfort | Discomfort increases with bladder filling and improves with bladder voiding | Yes, symptoms may improve with voiding and worsen with bladder filling | |
| Psychosexual issues/psychologic trauma | Generalized | Discomfort usually limited to sexual activity Symptoms may be absent with masturbation or noncoital sexual activity | Varies | |
