Negative for bacteria, antibiotics don't help, and you say the type of briefs you wear matters?
And you have no burning pain when you urinate?
There is a chance you don't have an infection.
And... if your pain mild in most mornings, but gets worse during the day, especially from sitting or lifting, then a leading possible answer is inguinal hernia. The fact the types of briefs you wear change your pain is a big hint of hernia -- pressure in the right place helps push in the intestines to where they belong, which is what a "Truss" does. You've just rediscovered an ancient temporary and partial solution.
Inguinal hernias can be small, difficult to find, and the pain is "referred" -- you feel it in your pelvis (epidymis, prostate, etc.), but the origin is in your inguinal canal where a tiny big of your intestines are pressing against your genitofemoral nerve. You feel better in the morning because when you're lying down, the intestine retracts and the nerve has chance to recover.
If you do have a hernia, unfortunately the huge majority (or all?) urologists are too ignorant to know. They'd prefer to give you antibiotics forever (that's what happened to me -- months and months of toxic Cipro and Levaquin, ugh!); although in my case I probably did have an infection, and maybe nothing less than Levaquin for 5 weeks would be enough.
So what you need if there's a chance you have a hernia is a hernia specialist -- ideally someone (1) who does nothing but hernias and (2) who knows the pain pattern (mild in the morning, worse during the day, especially from sitting or lifting).
Of course, everyone's situation is a little different and there are other possibilities:
- a different antibotic might work, like Levaquin or Flagyl. There is no one "strong" antibiotic -- different ones kill different things. There is a possibility (probably small) that you have a fungal infection. Fwiw, I subscribe to the view that masturbation can help while you're on antibiotics (it relaxes muscles, it helps purge bacteria if there are any, and it stimulates blood to your prostate that otherwise doesn't have much to do).
- Everyone (including me) seems to get stuck pushing their favorite solution, but there are there are more possible problems than infection or hernias, and a different solution for each. For example, kidney stones can also cause referred pain (your balls hurt but the problem is little painful things in your kidney or in the tubes on the way down), and they can also cause recurrent infections.
More info is below.
Luck!
Spy
northernspy @verizon.net
===========================
===== MANY POSSIBLE CAUSES OF PAIN TO CHECK OUT! == NOT JUST INFECTION ===
EXAMPLES OF DIFFERENTIALS FOR GROIN PAIN
http://www.physsportsmed.com/issues/2000/01_00/lacroix.htm
A Complete Approach to Groin Pain
http://www.physsportsmed.com/issues/1998/04apr/ruane.htm
When Groin Pain Is More Than 'Just a Strain': Navigating a Broad Differential
Joseph J. Ruane, DO; Thomas A. Rossi, MD
http://www.injuryupdate.com.au/ISMJGroinPain.htm
Pathophysiology of Chronic Groin Pain in the Athlete
====== STUFF ABOUT REFERRED PAIN ========================================
http://www.biomedcentral.com/1534-5874/3/327
Visceral Pathology Can Lead to Somatic Pathology
Sir Henry Head [12], who wrote that patients with bladder stones complain of 'pain in the perineum-pain at the end of the penis and pain over the ischial tuberosities
click on "Symptoms"
http://hernia.tripod.com/HerniaInstitute_index.html
PAIN
Pain occurs from hernias for several reasons, and can and does often vary in character (sharp, dull, burning etc.) and severity from patient to patient. Pain can occur because the tissue at and around the hole is being stretched or torn and therefor in some fashion damaged. This usually will cause pain directly at the site of the hernia and is Localized Pain. Pain may also occur as a result of irritation of or damage to area nerves as a result of the hernia and its contents pushing into or pinching the nerves. This too may cause localized pain, or may cause pain at a more distant area and is called Referred Pain. If the abdominal contents have become trapped or damaged within the confines of the hernia, as is the case with hernia Incarceration or Strangulation, the pain may well become more generalized in location and may even involve the entire abdomen if secondary peritonitis develops.
REFERRED PAIN
If the hernia irritates, inflames or damages nearby nerves, the pain felt from the hernia may not be at the site of the hernia, but rather at the area to which these nerves are traveling. For example, pain from an Inguinal Hernia may be felt as discomfort in the scrotum of men or the labia of women, or the back, upper leg and /or hip area. This is because nerves that supply sensation to these remote areas travel through the inguinal canal (site of the hernia) and may therefore be irritated or inflamed by the hernia itself.
http://hernia.tripod.com/types.html
INGUINAL HERNIAS Sometimes only a mild pain, ache or burning in the groin area may occur prior to the development of an obvious bulge. This pain, again often described as
an ache or burning sensation, may not only be present in the inguinal area, but may also radiate into the hip region, back, leg or even down towards the genitalia region. Called "REFERRED PAIN", this discomfort can be quite bothersome and at times severe. In addition, in the absence of a bulge, the diagnosis of the cause of this pain may be delayed or mistakenly and incorrectly ascribed to other causes such as muscular groin strains, epididymitis, prostatitis or orchitis etc. These diagnoses may be maintained erroneously until the bulge develops, thereby heralding the real cause of the pain...a hernia. The discomfort with hernias usually is initiated by or increases in severity with activity, then becomes relieved, although not always completely, with rest
http://www.aafp.org/afp/990215ap/817.html
www.leistenbruch.de/PatientLeaflet.pdf
The inguinal region constitutes a weak point in the abdominal wall. The weak point results from the fact that the so-called inguinal canal is located in the groin... ..Pressure on the nerves passing through that region – particularly the genitofemoral nerve – causes severe pain
http://www.medhelp.org/forums/gastro/messages/36693.html
It may be possible that the penile pain can be referred from the pain from the anal fissure. The fact that the symptoms are exacerbated after a bowel movement certainly supports this possibility.
