Thank you for the additional information.
This pattern of pain is most worrisome for pain in the epididymis, the tube that collects the sperm from the testicles and carries it up the scrotum, through the groin, and then into the pelvis to the prostate.
The most common cause of epididymal pain is from an infection of the epididymis, called epididymitis. This can be an acute infection with sudden onset of symptoms or a chronic infection with a more gradual onset of symptoms.
It is also possible to get epididymal and scrotal pain related to irritation of the nerves that serve the epididymis and scrotum, but this is less common and usually only considered after infection has been considered and excluded. If you were having the testicular, scrotal, and groin pain when you were seen by the Urologist, then he likely considered infection.
The usual treatment for epididymitis is antibiotics, and chronic epididymitis may require up to 12 weeks of antibiotics. Although several different antibiotics can be used, the most common first-line antibiotic is doxycycline
For nerve irritation, the most common approach is to use a medicine that suppresses nerve irritation, such as gabapentin or pregabalin.
The loose and saggy scrotum are non-specific and will typically improve as the underlying condition improves.
If I can provide any further information, please let me know.