what is an open bladder neck?

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? Can anyone offer me any insight into this situation? Has anyone experienced anything similar and had relief from anything?

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