What causes a slightly dull ache in both testicles, along with slightly cloudy urine and blood in sperm but no positive test results?

Hello doctor,

I have three months of bilateral dull testis pain that comes and goes. Also, occasional pelvic pain. I had testis ultrasounds twice, and both only showed a small varicocele on the left. No abnormalities. I did a health screen that included a whole-body MRI. This shows a “small volume of free pelvic fluid.” No other abnormalities. I have had several urine tests and cultures. Including several screens for UTIs, and they also included NAAT testing and serology for STIs—all negative every time. Occasional, once per week or so, slightly cloudy urine also, blood in sperm seen. All investigations (Urines, NAATS, Ultrasound, CRP) were negative: only findings except a random MRI that showed free fluid. The doctor thought it may have been infectious despite the negative test. Antibiotics tried included Ceftriaxone (250 mcg IM on three occasions), Metronidazole, Doxycycline 100mg twice daily for four weeks, Azithromycin, and Moxifloxacin for 14 days, followed by Azithromycin, followed by 14 days of Minocycline. After all this, the tests were always negative (and still are), and no urine cultures are always negative. Kindly help.

Hello doctor,

Thank you for the reply.

I had an MRI, and it showed a prostate of normal size. Also, my PSA was well under average. Can I still have the prostatitis with that? Also, if an STI caused this, would it have been shown in the NAAT urine tests? Moreover, are the medicine you prescribed going to help cure the issue, or are they supportive of pain? Kindly help.