4 months post exposure had another urethral swab, this time doctor did a DRE to get prostatic fluid in the sample - all negative (Diagnosed with prostatitis by DRE at this time) Was prescribed Bactrim for 10 days.

Symptoms of urine frequency and testicular pain continue so I had:

Symptoms started to get worse and spread pain to anus, legs, tip of penis, groing and started having some difficulty to start and maintain urine stream. Also very low force and quantity on ejaculation. Strong pain in perineum

I see in some questions Dr Handsfield stating that Chlamydia and Gono are often cured by the inmune system in a few months. Is this real? How long? Can the delay of testing (2 months) could cause the infection to spread to other areas of my body and not be found in urethral swab and urine testing?

My main concern is that I have an on going and undiagnosed infection because I have a regular partner and Id hate to bring some infection in. Up to this day (14 months post exposure) still have symptoms of testicular, groin, etc pain and urine issues like slow difficult and unsteady stream and sometimes high frequency

I was treated with antibiotics for other reasons between tests, so a few weeks before the 1st test I took 10 days of Cefixime.

3 weeks before 7month test I took azythro (1gram).

Could this also affect test results?

The exposure you describe, while relatively high risk, is unlikely to be related to your continuing symptoms.  Even most high risk commercial sex workers do not have STIs, when they do most single exposures do not result in infection and, in your case, you used a condom making the risk virtually zero as long as the condom was used throughout the encounter.  Further, your symptoms are not particularly suggestive of STI- urinary frequency is a sign off urinary tract infection (including prostatitis) and testicular discomfort in the absence of a urethral discharge is unlikely to be due to STI.   Finally, several of the drugs you have taken, including azithromycin and cefixime would likely to have cured the most common STIs- gonorrhea and chlamydia.  Finally, your subsequent multiple negative tests for STIs further make it most unlikely that your continuing symptoms are due to STI.  These tests are very sensitive and if an STI were causing your symptoms, the tests would be positive.  

In contacts, the symptoms you describe are quite typical of prostatitis. Consistent with your prior diagnosis of prostatitis, this may be what is going on.  It is not unusual for prostatitis to need 4-6 weeks of therapy to resolve.

If you have not seen a urologist, that is what I would suggest as a next step.  

I hope this perspective and the information I have provided is helpful. If any part of my answer is unclear, or there are further questions, please use your up to two follow-ups for clarification.  EWH

Just to give some more information, I did go to an urologist, in fact Ive been to many urologists and infectious disease specialist and no one has been able to find the roote cause of my symptoms and the tests just keep comming back negative for STIs and none of my exams show anything abnormal with my prostate and testicles. thats why Im concern maybe is something infectous and undiagnosed rather than anatomical. 

I havent had any evident discharge, but I have felt every now and then like something is dribbling but when I look theres nothing there. 

1) What troubles me is that my partner has been experiencing some symptoms of her own like urinary frequency and really really painful menstrual periods as she says “never felt before”.  Is it possible that I may have infected her with something?

2) Why do STIs cause testicular pain? Can it be as fast as 5 days post encounter? Since that is when I started having the pain. You say testicular pain is unlikely to be due to STI, but can it be?

3) I took 10 days of 400mg daily Cefixime, would this kill Gono? I took 1g only dose of Azythro 6months post exposure, would this cure Chlamydia if present? Could 6 months Chlamydia infection cause permanent damage and thats what I have?

4) Should I continue having sex with my regular partner or should I stop and retest and maybe get her to test on her own? (Obviously this last part will end the relationship)

5) Dont the results of my first urine test, positive nitrite and albumin and high WBC, with negative urine culture, suggest STI and not UTI? Every single urine test after that has come as normal as it can be. 

1.  I cannot comment on your partner.  I have no information about her.  She should seek evaluation with her GYN, is she has not.  If she has seen a GYN in the past year, the recommendations are that she would have been tested for STIs.

2.  Five days are too soon and as I said before, "testicular discomfort in the absence of a urethral discharge is unlikely to be due to STI".  When combined with (multiple negative tests, this is not an STI and you should be looking for other causes.

3.  As I said above, " several of the drugs you have taken, including azithromycin and cefixime would likely to have cured the most common STIs- gonorrhea and chlamydia".  The cefixime would have killed gonorrhea, the azithromycin would have cured about half of gonococcal infections as well as curing chlamydia if present..

4.  I presume that in the 14 months since the encounter that you now regret, you have had sex,  Ceasing sexual activity at this time is not necessary. Further, you have proven that you do not have an STI.  Your partner should be having regular sexual health checks as recommended for women- this includes testing for chlamydia, particularly if she has symptoms.  Getting checked for symptoms she might have, which are likely unrelated to an STI is not a reason for ending a relationship, it is following recommendations for routine health care.

5.  You have it backward.  These urine test results are far more consistent with a UTI (prostatitis is a UTI) than an STI.

My recommendations are unchanged.  See a urologist- tell him/her your entire story and work with them to address your concerns.  EWH

The issue about my partner visiting her GYN is that in my country, doctors screen for Chlamydia using blood tests and not urine tests, the only reason you get this is if you ask for it yourselves, and I understand blood tests for Chlamydia are not accurate so we wouldnt know the true result when she sees her doctor. 

1)My question is, do any of this on her side could be caused by a STI? Really painful menstrual periods and urinary frequency? Could this be PID? I understand if thats the case, is mainly caused by STIs.

I ask about resuming sexual activities with her because after the encounter, I was so scared that I stopped having sex with her for 6 months. In this 6 months I test twice by urethral swab and one by urine test and nothing came out positive, in this period I also took 1g of azythro. 

2) Do you believe I could have actually a misdiagnosed infection? Even today after I "resumed" sexual intimacy with her, I limit myself for 1-2 times a month because Im so worried, and now shes having all these issues.

3) Is it true that the immune system cures Chlamydia and Gono by itself in few months? Because Ive seen a lot of answers from Dr Handsfield stating this, but theres also a lot of info online about the serious consequences of not treating this infection for months or years.

4) What can I do to definitely rule out any infection? 

5) How reliable would a 1g of azythro be to cure Chlamydia in my case? Because I took it approx. 6 months post exposure, before having sex with my partner again.

6) Is it possible to test so late that infection is not found in the urethra  and transfered to other body parts and not found in urethral swab? Is there a time limit to test for infections?

7) If I took 1g of azythro 6 months after chlamydia, is it too late and already in need of stronger medication for longer period?

Thanks

1)My question is, do any of this on her side could be caused by a STI? Really painful menstrual periods and urinary frequency? Could this be PID? I understand if thats the case, is mainly caused by STIs.

Her symptoms are non-specific and could be caused by lots of things.  Not all PID is due to STIs and you have proven that you do not have an STI repeatedly.