"Of course the worst fear is a tumor/malignancy"

Sounds like you answered your own question. : )

Keep in mind most of his here are unusual in some way -- for most guys, the problems either go away, or they get antibiotics and the antibiotics work. That leaves guys with:

- resistant infections

- recurrent infections caused by hernias or kidney stones or strictures

- referred pain that gives the ILLUSION Of an infection, such as can be caused by inguinal hernias and kidney stones

- other anatomical problems (a cyst on a nerve, and... I donno)

or any of the things on the differentials below.

But not all urologists are incompetent. Wait I take that back. But some are at least systematic and can rule out the obvious possibities, which is enough for most patients. And probably most can tell the difference between a tumor or a cyst or torsion or whatever (the first thing they're supposed to do is rule out critical potentially emergency conditions); and in your case you can try to score a cheap and no-risk scrotal sonongram.

Doctors are great at some things. Once they know you need a heart replacement or a hip replacement or an apppendix removed, they follow a procedure and usually get amazing results. They suck at diagnosis, but they should be able to tell a cyst from a tumor. Get the critical stuff ruled out in 5 minutes, see a second quack if you don't trust the first one, then go buy a beer and by happy you don't belong on this list.

Because you might also find you DO have an infection or some damn thing, and then ignoring it would be dumb.

Spy

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THREE LISTS OF POSSIBLE EXPLANATIONS

http://www.physsportsmed.com/issues/2000/01_00/lacroix.htm
A Complete Approach to Groin Pain

http://www.physsportsmed.com/issues/1998/04apr/ruane.htm
When Groin Pain Is More Than 'Just a Strain': Navigating a Broad Differential
Joseph J. Ruane, DO; Thomas A. Rossi, MD

http://www.injuryupdate.com.au/ISMJGroinPain.htm
Pathophysiology of Chronic Groin Pain in the Athlete