Chronic Problem, any insight appreciated

[Androsynth]

I have posted a few months ago in Urology, but the problem persists, so I will post it again here.  I hope that's OK.

Symptoms:
* minor but near-constant discomfort and heightened awareness of the urethra and/or meatus
* over-sensitivity of penis tip to contact with underwear
* meatus opening often seems a little swollen / puffy ("lips" appearance)
* somewhat increased urinary urgency and frequency - first void of the day seems especially, unusually urgent
* mild dysuria (not always)
* some days, a stinging sensation in meatus / urethra which persists for 10-20 minutes after urination
* discomfort often flares just after a shower
* stinging sensation immediately upon entering a swimming pool
* looking inside urethra at any time, I can see some clear moisture deep inside - even some time after urination
* symptom duration for over 1 year

History
* symptoms began 4 days after a "low risk" one-time encounter with a "high risk" female - no genital-genital contact, just manual stimulation with an unknown lubricant oil followed by condom-protected oral sex

Other Observations:
* no lesions, discharge, or odor ever observed
* no perineal pain

Workup thus far:
* gon / chlam tests both negative (twice)
* other std tests negative (hiv 1&2, hsv 1&2, syph)
* many urinalyses, all entirely negative, except for some at symptom onset which showed small amounts of blood (microhematuria)
* three urine cultures, all negative
* two digital rectal exams by different doctors, "seemed pretty normal"
* cystoscopy revealed "possibly a little irritation" in urethra, but no obvious infection; bladder normal
* bladder / kidney ultrasound: normal
* multiple visual inspections at urologist: normal
* PSA very low (normal)
* various other blood work (CBC, ANA, etc.): all normal

Medications Tried (all failed):
* doxycycline, 10 days
* cipro, 14 days
* azithromycin (z-pack)
* ketoconazole (two 400mg doses)
* metronidazole, obtained as pure powder from tropical fish store and mixed with water, attempted to take 2g dose, but impossible to measure exactly

I'm not sure what to do next.  Is there any test that the doctors have missed, or any other specialist I could see?  Any alternative / natural therapies which could help?  Is there any kind of fastidious bacteria that could persist this long and never show up on any tests nor respond to the meds I've taken?

Any response is much appreciated.

[NOHARD]

Hi all you can do is what you are doing now, and thats just keep trying for the right test, but its a funny world when you think we know it all, but some things keep hiding.
Good Luck

[Androsynth]

Just researching online it seems that there are many men out there who have an issue like this.  Most go through the whole gamut of tests and drugs without finding a diagnosis or cure.  My doctors have insisted that I have no infection of any kind, but I will definitely request a urethral swab in case it can pick up something that the other tests have missed.  Maybe check for Mycoplasma while they're at it.

Maybe I should also request a semen culture - weird that my urologist hasn't ordered one but it seems that not all uros do that.  Hmm.

I have also considered the possibility of an injury or nerve damage of some sort, but if that were the case it surely wouldn't take 4 days for the symptoms to begin.

[NOHARD]

Hi Well atleast we are thinking along the same lines, if its any help, sorry I cant be of anymore help, the trouble is that as men we only get 1 life and 1 p***s, and we cant swap a p***s when it gets sick.
Good Luck

[Androsynth]

Thanks for responding.  From what I've read it's near impossible to confirm HPV in a male, unless there is an actual wart or lesion to be swabbed or biopsied.  There's also no treatment, so if that's what I have then I'll just have to live with this.  As for an undetectable gonorrhea, it's theoretically possible, e.g. a cell wall deficient strain, but kind of a long shot due to (a) low risk encounter (b) no discharge and (c) no response to drugs that would normally treat gonorrhea.  At some point, I may request a urethral swab test which may be better able to detect gon.  

[NOHARD]

Hi After doing some reserach on a couple of things, there are some STDs that dont show up on tests, and both HPV and Gonorrhea can give big problems in finding them on tests, and I think HPV can have many guises and not just warts, I think your best bet would be to do lots of reserach into STDs and STIs.
Good Luck