Chronic pelvic pain in men is one of the most frustrating conditions in urology — persistent, hard to pin down, and too often dismissed. Pain in the lower abdomen, groin, perineum, testicles, or lower back can linger for months and resist the usual fixes, leaving many men bouncing between doctors without answers. The reality is that pelvic pain almost always has an identifiable cause, or combination of causes, and a thorough, multimodal approach can bring real, lasting relief.
Dr. Justin Houman is a board-certified urologist and Fellow of the American College of Surgeons whose subspecialty training in male reproductive medicine and microsurgery is held by fewer than 2% of urologists in the United States. His practice is recognized as a Center of Excellence for chronic testicular pain, and his microsurgical expertise in nerve-related pain — including spermatic cord denervation — makes him especially well suited to the complex, often nerve-driven causes of male pelvic pain. An Assistant Professor of Urology at Cedars-Sinai Medical Center featured in national media including Men’s Health and the New York Post, he brings a comprehensive, multimodal approach to a condition too often undertreated.
I recommend Dr. Houman for any urology need whatsoever. No question he will handle and take care of you and will make you feel comfortable throughout the entire process. He and his staff are reachable and answer all of your questions and concerns. If you are looking for someone like that, look no further.
What Is Pelvic Pain in Men?
Pelvic pain in men is persistent or recurring discomfort in the lower abdomen, groin, testicles, perineum, or lower back. It can be acute and short-lived or chronic, generally defined as lasting more than three months. Chronic pelvic pain is common yet frequently overlooked, in part because it can arise from several overlapping sources at once. Pinpointing those sources is the foundation of effective treatment.
Symptoms of Chronic Pelvic Pain
Men with chronic pelvic pain may experience a range of symptoms:
- Aching, burning, or stabbing pain in the lower abdomen, groin, or perineum
- Pain in the testicles, penis, or rectal area
- Frequent or painful urination
- Painful ejaculation or discomfort afterward
- Tightness or spasms in the pelvic floor muscles
- Lower back pain linked to pelvic discomfort
- Pain that worsens with prolonged sitting
How Male Pelvic Pain Is Treated
Because pelvic pain usually has more than one driver, treatment works best when it’s multimodal — combining approaches rather than relying on a single fix:
- Pelvic Floor Physical Therapy: Often the cornerstone — relaxing and retraining the pelvic floor muscles that drive much of chronic pelvic pain.
- Medications: Anti-inflammatories, alpha-blockers, and neuropathic pain medications, matched to the underlying cause.
- Trigger-Point Injections and Nerve Blocks: Targeted treatment for tight muscles or nerve-related pain such as pudendal neuralgia.
- Lifestyle and Stress Management: Reducing bladder irritants, stretching, and approaches like cognitive behavioral therapy to ease pain and tension.
- Treating the Underlying Cause: Addressing a specific driver — prostatitis, a nerve entrapment, or chronic testicular pain — directly when one is identified.
A Multimodal Approach to Lasting Relief
What sets effective pelvic pain care apart is recognizing that the pain usually has more than one source. Nerves, muscles, inflammation, and stress often feed into one another, which is why treatments aimed at just one of them tend to fall short. Dr. Houman’s approach is to identify each contributing factor and address them together — and his microsurgical expertise in nerve-related pain gives him options for the difficult, nerve-driven cases that frustrate many practices.
Common Causes of Male Pelvic Pain
Pelvic pain in men can stem from one cause or several working together:
Chronic Prostatitis / CPPS
Ongoing prostate-related pelvic pain without infection — the most common cause; learn more on the
Pelvic Floor Dysfunction
Tight or poorly coordinated pelvic floor muscles that generate pain and tension.
Pudendal Neuralgia/Nerve Entrapment
Irritation or compression of pelvic nerves, causing burning or shooting pain, often worse with sitting.
Chronic Testicular Pain
Persistent testicular or scrotal pain (orchialgia), a focus of our
Interstitial Cystitis
Chronic bladder irritation causing pelvic pain and urinary urgency.
Other Causes
Urinary infections, hernias, and musculoskeletal issues can also contribute.
Frequently Asked Questions About Pelvic Pain in Men
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Burning, shooting pain that worsens with sitting can point to pudendal neuralgia or nerve entrapment; Dr. Houman has particular expertise in identifying and treating nerve-related pelvic pain.
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Yes — with an accurate diagnosis and a multimodal plan, most men achieve meaningful, lasting relief, even after previous treatments haven’t helped.
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Much chronic pelvic pain isn’t caused by infection, so antibiotics often don’t work; pelvic floor therapy, nerve-targeted treatment, and other approaches are usually more effective.
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Yes — stress and anxiety can tighten the pelvic floor muscles, which can trigger or worsen chronic pelvic pain, making stress management part of treatment.
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For many men it’s one of the most effective treatments, since pelvic floor muscle tension is a major contributor to chronic pelvic pain.
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Chronic prostatitis/CPPS is the most common cause of male pelvic pain, and the two overlap closely — which is why evaluation looks at the whole pelvic region.
Why Choose Dr. Houman for Pelvic Pain Treatment in Los Angeles
- Expertise in Nerve-Related Pelvic Pain: Microsurgical skill for complex, nerve-driven cases.
- Center of Excellence for Testicular Pain: Deep focus on chronic male genital and pelvic pain.
- True Multimodal Treatment: Addressing nerves, muscles, and inflammation together.
- Answers After Dead Ends: Thorough evaluation for men who haven’t found relief elsewhere.
Meet Dr. Houman
Expert in Men’s Health with Tower Urology and Cedars Sinai
Dr. Justin Houman, MD, FACS is a board-certified urologist and fellowship-trained microsurgeon at Tower Urology, Cedars-Sinai Medical Center in Los Angeles. His subspecialty training in male reproductive medicine and microsurgery is held by fewer than 2% of practicing urologists in the United States.
His clinical focus is narrow by design. Varicoceles, chronic testicular pain, male infertility, vasectomy, testosterone optimization, erectile dysfunction, penile implant surgery, and Peyronie’s disease are not add-on services here. They are the practice. Patients travel from across the country and internationally for procedures, particularly microsurgical varicocelectomy, spermatic cord denervation, and inflatable penile implant surgery, that require a level of subspecialty training and surgical volume most urology practices do not have.
Pelvic Pain Treatment in Los Angeles
If chronic pelvic pain has taken over your life — and especially if you’ve been told there’s nothing more to do — a fresh, thorough evaluation can open the door to relief. Dr. Houman offers comprehensive, multimodal pelvic pain care for men across Los Angeles and Southern California. Contact the Los Angeles office to schedule a consultation and start working toward answers.
