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.