BMI 29, normally healthy and active, no previous issues. alcohol consumption above weekly recommended 40 units plus.

When I get the urethral issue I can milk my penis and produce a clear fluid more viscose than urine. There's also a urine drip.

Ref bowel movement, the drip\discharge can defenetly be more pronounced during a bowel movement.

To cut to the chase, I am confident you did not acquire any STD from the sexual exposure described; and on the off chance you did, for sure do not have any persisting STD now to explain your symptoms. Further, I think your doctors are on the right track in suspecting a psychological origin for your symptoms and their decision not to treat you with any further antibiotics. Those would be my exact recommendations if you were my patient.

Here is my reasoning. First, you had a low risk exposure. While some STDs can be acquired by oral sex, in general it is safe sex with very low risk for all STDs and zero for some. Second, your symptoms are not typical for any STD and never have been; while on the other hand, they are absolutely textbook typical for the symptoms of genitally focused anxiety. Third, having a few WBC in the urethra does not, in itself, warrant a diagnosis of NGU or any other STD. Entirely healthy men often have a few WBC in their urethras from time to time. Fourth, the lab tests for STDs other than NGU are highly accurate -- and you had multiple negative results. There is no chance they missed any infections. Fifth, if despite all this you in fact had NGU or some other STD, the treatments you had would have cleared them up. The persistence of your symptoms despite antibiotics is not evidence of a resistant infection; it is rather evidence you had no infection at all. Sixth, expression of fluid during defectation happens to many men from time to time and isn't in itself abnormal; it's just stool pressing on seminal vesicles and prostate as it passes through the rectum. Similarly, almost any guy can milk a little clear fluid from his urethra if he tries hard enough; and repeated efforts can actually increase mucus flow, making it easier than before.

This does not mean I believe you are "dreaming up" your symptoms. The pain and discomfort are not just in your head. The urinary urgency, genital or pelvic discomfort, and all other symptoms like yours have a physical cause -- specifically, tension in pelvic muscles. But that tension definitely can be (and usually is) the result of psychological factors. It's basically the same pain mechanism as a tension headache, which results from muscular tension (neck, scalp muscles, etc); nobody denies the pain is real, but in addition nobody denies that stress or anxiety cause it. Why should the genital area be any different?

So my advice is to just let this go. For sure you have nothing that will ever harm you or your current or any future sex partners. You should be having unprotected sex with your wife; it will probably do you more good than anything else I can think of. Humans sometimes have to live with unexplained aches and pains; it doesn't necessarily mean disease. If it continues to bother you, then professional counseling is the best next step. Whatever else, stop pursuing further attempts at medical diagnosis or treatment. It won't get you anywhere except to further  accelerate your "downward spiral" and dysfunction when it doesn't provide answers.

I hope this has been helpful. Best wishes--  HHH, MD

The reason I'm in a spin on this again is that my Wife has mentioned a sporadic hip pain which she's put down to jogging, she has mentioned it occasionally over the last 2 months which would be + 10 months since my exposure, can see in my original post I said how I'd resumed normal relations after the first STI suite of tests were negative. My Wife had 1 gram antibiotic as per original, would PID be causing hip pain only after 10 - 12 months? Would the antibiotic not have been effective in April.

I can't decide if I'm in 1. Denial and there is something wring despite all the science to the contrary or 2. I'm in a mental state.

Thanks again, what's your opinion on oral transfer Clhamydia and on PID?

Your wife's symptoms also don't hint at an STD or any other consequence of the sexual exposure a year ago. And PID doesn't cause hip pain.

I can't say for sure the cause of all your symptoms, but many or most are almost certainly psychological in origin, as I said above. Whatever the cause, they are not from any infection from your sexual exposure. It seems very clear that your mind has conflated your axieties over a sexual choice you regret with the potential infectious consequences of that event. They are not the same. Deal with the former as you need to, but disregard the latter.

I've got some cbt coming up, hopefully I can use this as you suggest.

Regards