Do I need a long-term course of Doxycycline for my testicular pain?

Hi doctor,

My symptoms are as follows. Pain in the right testicle, swelling at the top of the right testicle and some redness on the urethra, especially after ejaculation. I had Chlamydia about 18 months ago. I was tested positive and treated with two antibiotic pills, which seemed to cure it. After six months, the test came back all clear. They also checked for syphilis, gonorrhea, and HIV. All came back negative. Syphilis IgG or IgM by EIA - negative, HBsAg - negative, hepatitis C antibody ELISA 3rd generation - not detected, HIV 1 and 2 ABS or P24 antigen screen - not detected, Chlamydia trachomatis DNA (PCR) - not detected, N.gonorrhoeae DNA (PCR) - not detected, Mycoplasma genitalium DNA (PCR) - not detected, Ureaplasma species DNA (PCR) - not detected, Trichomonas vaginalis DNA (PCR) - not detected, Gardnerella vaginalis DNA (PCR) - not detected and herpes simplex type I/II DNA - not detected.

Six months ago, I started to experience the symptoms. When I went to the doctors, they gave me a 9-day course of Doxycycline as they suspected epididymitis. It seems to clear it up in about five days, and I was even cycling and running again. A week after the course of Doxycycline, the symptoms came back. I read on the internet that the bacteria, which can find itself in all sorts of places as the tubes in the testicles can be like a network of caves and it can be hard to kill off completely. I visited the sexual health clinic. They gave me a 14-day course of Ofloxacin, which slightly reduced the symptoms. They seemed reluctant to rerun a Doxycycline course as they said it came back after taking it the first time. Do I need a long-term course of Doxycycline to work really?

I had an ultrasound scan to reveal that I had an epididymal cyst, but currently, there is no pain. The doctor advised it would cause no harm and I would have to live with it. It is about the size of a pea. Over the last few months, the epididymal cyst and redness remain on the scrotum in that area and slight rash or redness on the penis glad. The urologist put me on six weeks of Cipro, which seem to lower the irritation and symptoms by 60 %, but never really cleared it up. Then, I have had a urine culture test, and it came back with the following. Please note the following antibiotics Augmentin, Cefpodoxime and Ciprofloxacin should not be used as the first choice if alternatives are available. Urine culture more than 100,000 CFU/mL mixed growth of organisms with a predominant growth of an Escherichia coli. I am a bit lost where to go next as after six weeks of Cipro I still have the E.coli culture coming back as positive.

Thank you doctor,

Could the cyst or abscess on the epididymis be infected? I guess the antibiotics are not killing the infection entirely due to a collection of pus?