Brief Answer:
MRI

Detailed Answer:
Hi R'.

Thanks for your query and an elucidate history.

After carefully reading the history provided by you I could relate some points, which I would like to talk about ::

2 years- constant burning at the tip of urethra - 2 urologist did scopy and declared urethra to be normal- no STD- on antibiotic- red bumps n glans which are not seen but sensitivity is painful - ''The tip of the urethra at the head feel like a razor is slicing'' > specific > - throughout the day - epididymitis 15 years ago - esophagitis with gastritis - got treated and under diet control - redness and irritation at the tip - Wife slightly concerned with her burning sensation - frequency during night and after biking - Urgency, difficult to hold back. And few more points as you have mentioned.

#''The tip of the urethra at the head feel like a razor is slicing'' .
This is a very atypical presentation of any known disease. I can think of either a local cause like a neuroma meaning the nerve fibers have gone into enlargement in response to chronic irritation or so (idiopathic). Such pain is also described by someone who has post-herpetic (Herpes zoster, not simplex) neuralgia. There may not be a typical finding except Redness/irritation in tip of opening, which you have mentioned.
Another possibility is that there is some irritation at the sacral spinal level which is irritating the pudendal nerve to cause such a problem.
This can explain the extra sensitivity at the glans and can have a problem related to the jerks at mountain bike ride, I say can be.

#Wife slightly concerned with her burning sensation. IN all such problems I would prefer to treat both the partners simultaneously with an antibiotic ( which you are already on ) and metronidazole and a single tablet of an anti-fungal tablets.

Occasional Cloudy urine, odor may not of significance.
Frequency during night , after biking and difficulty to hold back can be due to the irritation you have.

I would advise you MRI of the Pelvis related to the origin and distribution of the Pudendal / Dorsal nerve of the penis.

Please post a picture of the tip of urethra and glans if possible.

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Brief Answer:
As discussed .

Detailed Answer:
Hi.

IT is OK if there is no photo. If the small bumps are along the corona part of glans, this is normal.

Since the urethroscopy is normal as done by 2 Urologists, the dribbling may be related to prostate.

It is good to know that your STDs are normal, that you have ordered Metronidazole.
Pelvic MRI is needed, please go ahead. Damaged nerves do not cause pain, the pinched or entrapped nerves cause pain. It is possible to get a finding on MRI or at least help us to rule out this particular problem.

Reiter's Syndrome :: this again is a rare diagnosis to make. There is a classical triad of Arthritis, urethritis and conjuctivitis. Occasional burning of the eyes may not fit into Reiter's. Clinical picture is dominated by Arthritis, which is severe enough not to be forgotten. There are few tests you can undergo but there is no specific test to prove. It is the classical clinical picture. The pain is along the whole urethra and the triad is not routinely seen due to usage of antibiotics so frequently.

For Nerve Pain: A trial of Gabapentin / Amitryptiline or Tegritol can be taken under consultation of your Doctor. This can be just a test.. If it helps you become symptomatic or at least have bearable symptoms.

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