About three months ago, I received unprotected oral sex from a woman of questionable STI status. I immediately (within hours) began experiencing psychosomatic symptoms, e.g. an unrelieved stinging sensation at the urinary meatus. Because my perception of its magnitude changed depending on how focused on other tasks I was, I attributed it to classic genitally-focused anxiety and a lack of a definitive, negative N. Gonorrhoeae NAT/PCR. Life went on.

Last month, I took a 5-day regiment of azithromycin for sinusitis and, around day 4, had a episode of acute right testicular pain, washing away any self-assurance I may have had. I'm not sure if the anxiety or the nausea was worse. Anyway, the pain subsided but didn't disappear over the next few days and, fearing some kind of transient torsion event since there was no trauma, I went to a urologist.

I reported my last new partner as being two months prior, no discharge, and no change/pain on urination. After an ultrasound of my scrotum, bladder, and prostate, he palpated my epididymis and I left with fourteen days of doxycyline and cipro for epididymitis, in spite of the lack of tenderness/swelling for "due caution." The in-house UA showed neither leukocyte esterase nor nitrites. I'm not sure if he sent my urine off for STI checking. My yearly nephrologist visit the next week ruled out referred pain.

The stinging meatus sensation is as prominent as ever now, especially when I have to urinate. I realize its probably not the gram-negative superbug that my brain occasionally thinks it is, but the continued unreproducible-on-palpation testicular discomfort is worrisome.

So:

Is it possible the azithromycin knocked down a potential urethral infection to a point where I'd have a clean UA?

Is gonnoccocal epididymitis, sans discharge, even a possibility two months in?

Any thoughts on where to go from here? NSAIDs are a non-starter thanks to CKD, but the endless focus on my mid-section is wearing me a little thin.