Brief Answer:
Quite a few causes sir

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help.

I should rightfully start by telling you that there are quite a few causes for a presentation similar to yours sir. And treatment can only be accurate and effective if the specific cause is treated, any treatment initiated without knowing the cause would only be considered blind treatment.

I shall list all the most common causes out for you sir. They are:
-Orchitis (inflammation of the testes): Most common cause for such a presentation
-Prostatitis (inflammation of the prostate)
-Epididymitis (inflammation of the epididymis)
-Infections (eg. chlamydia)
-Testicular torsion
-Urethritis (inflammation of the urethra)
-Cancer (rare): Eg. prostate cancer, bladder cancer
and a few others.

As you can see sir, the causes are various and all require a different treatment approach. I would recommend you to schedule an appointment with a urologist and go about an elaborate evaluation including a pelvic ultrasound, urine analysis, digital rectal examination, etc.

I hope you find my response both helpful and informative sir. Please feel free to write back to me for any further clarifications, and I would be more than happy to help you. In the meantime, please do abstain from sexual intercourse until your doctor deems it safe sir.

Best wishes.

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