what is an open bladder neck?

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I have been experiencing bladder problems ever since a catheter was unnecessarily and improperly inserted in me. Unnecessary because only 30 mL of urine came out. I could have been given medication to counteract the medication I was taking at the time to void normally. My bladder was never scanned prior to inserting the catheter and no physical check was done of my bladder or pelvic area for distension. Improper because a very rough nurse just basically jammed the catheter in me without ever sanitizing or lubricating the area first and did not put it in, wait for urine to draw, and then open the balloon as I now know is the proper way to do it. I have been to six urologists to date including the best hospitals that NYC has to offer including NYU, Columbia, and the latest in Mt. Sinai. I went to go see a reconstructive urologist in Mt. Sinai because every other sort of treatment or procedure I have done has failed. I have tried pelvic floor exercises twice, both times using rectal suppositories including external and internal stretching, as the second time I also had pelvic floor injections. I later went on to have botox injected into the pelvic floor as well. I do have pain in all of my pelvic area as well as my rectum and perineum because I contracted an infection from the catheter that was not treated properly and my urination issue has not responded to any of the antibiotics given. I even went to an infectious diseases specialist to take specific strong anti-biotics for this type of infection. I have also taken tons of Flomax, Alfuzosin for a while, many OAB medications including Myrbetriq, Detrol at the max dose, and Oxybutinin. I have also taken Elmiron for six months as a trial for interstitial cystitis. I also went through almost two months of bladder installations with no effect. I tried a two day trial of interstim which failed, however I felt the sensation in my rectum and not in my pelvis as my current doctor says should have been the case. I tried PTNS therapy for almost three months and after all this my urination issue still persists. I can get used to the pain but I cannot function with this constant leaking of small amounts of urine into my urethra out of my bladder into my urethra that causes a constant urge to urinate. It is non-stop from morning till night as I go to sleep with the sensation and it continues after I wake up and urinate in the morning. I had urodynamics testing done and it showed that I was retaining urine as I urinated out almost more than 200 mL of what was put into me. My stream was also quite weak as it is half what it is supposed to be. The doctor I had at the time gave me a ridiculous reason for this suggesting that I might have been shy because the techs were in the room. That is how I urinate normally as I have hesitancy even in the morning when I have a full bladder of urine built up from sleeping the whole night. I take medication for sleep or else I would be up the whole night urinating. The reconstructive urologist is going to run videourodynamics to see how my bladder neck and both urinary sphincter muscles are working more accurately. He said that I could have an open bladder neck and the treatment option would be to tighten the bladder neck. All that I can find from my searches on google is something called bladder neck obstruction and a lot of my symptoms match that diagnosis. However I see that the treatment for this is to open up the bladder neck and not tighten it. I am really confused at this point. I am starting to get pretty hopeless and desperate at this point for them to relieve me at least somewhat of this situation because my whole life revolves around the toilet. I can urinate literally hundreds of times a day. I do not have any strictures in my urethra which was seen on a regular cystoscopy. Also, I do not know if any medications will affect the test as I currently take large doses of a muscle relaxant called Flexeril and Flomax two times a day. I have to call the office prior to the test and see what I can and cannot take and for how long. My thinking is that the Foley catheter balloon was opened up in my bladder neck area and stretched out my bladder neck as it has never been able to recover. When the catheter was taken out I felt a sharp pain at the base of my penis and for one to two weeks after I had a very hard time urinating as it was coming out very dark and in small amounts with a lot of straining. One morning I woke up and started urinating non-stop. Since then I have gotten to the point of being able to hold it for hours but that sensation of having to go is always there. Can anyone give me some information to read about what can go wrong with the bladder neck. I know that catheters can cause bladder damage, but the urologist did not seem to think this was possible. He doesn't know if a surgery would really help me that much. Can anyone offer me any insight into this situation? Has anyone experienced anything similar and had relief from anything?

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  • Posted

    Surgery is only considered the last option. You could try enhancing your immune and body repair system by natural food supplements or nutritional food supplements. I am currently experiencing freaky urinary behavior that gives me much depression after I hurt it months ago. I am relying on my body's natural repair function with the help of food supplements.

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    • Posted

      I have tried dozens of supplements already. I have no choice but surgery at this point. It has been years already. Since everything else has failed I am almost out of options. Believe me when I say I have been trying to fix this anyway possible. There is nothing I can really do on my own when there is something structurally wrong. It's like if I developed scarring from the catheter. I can't fix something like that without surgery. How long ago and how did you hurt your urinary tract?

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    • Posted

      I hurt my perineum part late March this year. I am having urinating issue and a bit of spasm where my prostate is... I have been so worried these past months...Some say they got relief using Bee Pollen. My option for now is supplements. Especially Bee Pollen.
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    • Posted

      I have tried bee pollen. It is a relatively inexpensive supplement that I got from GNC. It was annoying that I had to take several pills throughout the day. I took it for a couple of months. I have also taken supplements for the prostate bladder and urinary tract in addition to all the medications I've taken. I hope you get better soon because urination problems can seriously impact your quality of life. I haven't been able to work since mine started and I am ready for it to be over hopefully by the end of this year through surgery. I saw the doctor relatively quickly and he is very experienced as I saw him at a top hospital in NYC. My test was set up for 2 1/2 weeks after so I'm hoping within a month or the two at most after that then they can schedule my surgery. I can really feel my problem as it feels like something is open at the base of my penis. I have tried physical therapy too and I believe it is a waste of time. This won't be a major surgery I will be doing. It's just to tighten the bladder neck back up. I of course am doing my research into it but there is so much out there that you kind of get lost in all of it. Going on nearly three years with this has honestly drove me a little nuts. You can see if physical therapy will help you. It is helpful in relieving the pain but it is also exhausting as mine was very involved and took me a good couple of hours every day. Certain exercises help too as exercise helps with pretty much everything to keep things loose. I know that there are supplements for inflammation too which you can try. Everything down there is connected from your perineum running through several muscles all the way up to your tailbone so a lot can go wrong down there. Urination involves a lot more than just feeling the urge and then letting it out. It involves your whole nervous system and parts of your musculature down there. I know that certain foods and beverages can also affect urination. I have been to so many urologists and have become so involved in this that I know way more than I should or would even like to know. My plan was just to teach and live a simple life, but I was thrown this curveball.

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  • Posted

    First of all, I would suggest that you ask this question in the Prostate forum which has lots of experienced members. I was advised to open a new thread in order to get more responses, and that advise was good for me.

    Your experience could have been mine, and I shudder to think.  We do have some similarities.  I had a Sudden Onset Bladder Retention.  The ER nurses were very confused.  It took painful hours for the good ER doctor to do a rectal exam and order an bladder ultrasound immediately.  The nurse saw a full bladder and said, "You just bought yourself a catherer".  However, she didn't wait the 10 minutes for the anesthetic gel to work, and iirc, didn't hold my peenee closed to hold the gel, as is suppossedly required, according to experienced Prostate posters.

    More like yours is the bloody disaster when my Foley was taken out by a locum.

    My uro said I would most likely pee normally after the Foley was removed.  However, I couldn't pee, and tried to self-cath with a hydrophilic catherer.  Problem was, there was mucoid blood in my bladder/urethra.  So, ran back to the ER. Three hour wait, while the ER doctor consulted urologists, because my problem was "unusual bad luck".  Then, the ER doc just ordered a bladder scan.  They had problem getting the scanner out quickly from storage.  Oddly, my bladder only had 397mL in 7.5 hours; whereas, it would normally have 2+ liters.  Anyway, a new Foley was ordered to go in, but the cathing nurse had a hard time getting urine/blood to flow.  I lost maybe a liter of blood for many hours.  My blood pressure dropped from approx 155/95 to 120/70 for most of a day.  

    The ER doc's words, "bad luck on your Foley removal".  I also have a slit below my pee hole which as of yesterday wasn't fully healed.  Apparently, it's important to put some antiseptic gel there, but no one told me until two days ago.

    You'll see my Catch-22 situation in the Prostate forum.

    Yes, I agree with your statement:  " I know that catheters can cause bladder damage, but the urologist did not seem to think this was possible. "  .. because my uro said to just go to a walk-in clinic to have the cath removed.

    A hospital nurse told me, as I was leaving, and waaay to late, to get Ativan prescribed so that I don't thrash about during cathing or removal.

    Also, it takes, according to a poster, 10 minutes for the gel to numb the urethra ..  another poster said 20 minutes.

    There is also the issue of "false passageways" apprently from bad cathing or self-cathing.  Very obscure issue.  I got the causation info from my uro.

    I am going with the least-invasive, least-damaging therapy, one at a time, and not jumping into the surgical table, before meds or herbs, have been given a chance.  That's based on advise from these forums; it's a good "tribe" to be in.

     

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