Thanks for the thanks. Glad to be of help.
As I said, I doubt any of this was explained by a bacterial infection and am not convinced any antibiotic was necessary. But if treatment was to be given, the drugs you had were just fine. Clarithromycin is just as effective for prostate infections and urethritis as is erythromycin (of which EES is one type).
This was definitely the best Doctor/patient interaction I have ever had! I cant thank you enough for your extensive knowledge and the kind manner in which you advise. If you could bear with me for a final question or two that evolved from your response, I will conclude with finality and peace of mind....
Did my GP prescribe correctly with the Clarithromycin/metronidazole? I read EES was prefered, so was I exposed to an antibiotic that would essentially not do the job?
Also am I correct in translating that you would not advise STD testing at this juncture? (I know the "happy ending" exposure was not risky) I am just so perplexed as to how this whole thing correlates within 48 hours of the massage......
I immensely appreciate your time and efforts.
Putting all this together, it seems likely you have a prostate gland problem. I'm skeptical the initial problem was acquired by the oral sex event in the massage parlor. It is rare for sexually acquired urethritis to not resolve with the several initial antibiotics, and it could be that the symptoms finally resolved spotaneously, not because of the levaquin. Now I suspect the same problem has recurred. You current symptoms cannot possibly have been due to an infection acquired during your more recent massage event, "happy ending" or not.
I used the term "prostate problem", not "infection" or prostatitis, with care. Most cases of prostate inflammation may not be due to infection at all, but some other kind of inflammation. Antibiotics often are tried, but as you have found, they often don't make much difference -- which is part of the evidence that infection is not involved. Because of the way the nerves are distributed in the genital area, more internal problems, like prostate, tend to cause pain or discomfort at the tip of the penis -- so the location of that symptom does not necessarily indicate a urethral infection.
As far as potential harm to your wife, or to your health in the long term, you have no worries. Chlamydia or gonorrhea are not a concern. Prostate problems of this sort are not sexually acquired or transmissible; and in the slim chance I am wrong and that the initial problem indeed was sexually acquired, there simply are no sexually transmitted germs that could persist and cause harm in the face of the several antibiotics you have received.
Your experience with your primary care provider is fairly typical. Prostate inflammation and related issues are complex and often not well understood by GPs. Your use of "GP" suggests you might be in the UK (they're mostly known as family practitioners [FP] in North America). If so, consider a visit to your local genitourinary medicine (GUM) clinic for expert evaluation; or ask your GP to refer you to a urologist. I don't anticipate any surprises will be found, but evaluation by an expert likely will go far in calming your fears about long term health outcomes for either you or your wife.
Finally, long before coming to your closing comment, I did not suspect a psychological origin of this problem, even though such conclusions are common on this forum. Your willingness to "live with the pain" as long as there is no risk to your wife is a mature and healthy attitude.
In summary, almost certainly no STD is responsible for these problems and I see no risk of serious health outcome for either you or your wife. You may or may not have to live with your symptoms, but they should not be cause for great concern.
I hope this helps. Best wishes-- HHH, MD