Method for providing support to a urethra in treating urinary incontinence

• US 10,639,138 B2
• Filed: 01/30/2018
• Issued: 05/05/2020
• Est. Priority Date: 02/28/2008
• Status: Active Grant

• Current Assignee: Coloplast A/S
• Original Assignee: Coloplast A/S
• Inventors: Browning, James
• Primary Examiner(s): Lacyk, John P
• Application Number:
  US15/883,110
• Publication Number:
  US 20180153672A1
• Time in Patent Office: 826 Days
• Field of Search: 600 29- 32, 600 37
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0435 the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61F 2/0045 Support slings
• CPC Class Codes: A61F 2250/0004 adjustable

Abstract

A method for providing support to a urethra in treating urinary incontinence includes passing first and second elongate members coupled to a urethral support through an incision in the vaginal wall, around sides of the urethra and behind a pubic bone. The method includes locating the urethral support under the urethra applying tension to one of the elongate members with a rotary force tensioner and adjusting tension of the urethral support.

Claims

1. A method for providing support to a urethra in treating urinary incontinence, the method comprising:

forming an incision in a vaginal wall and opening a site for introduction of a urethral support;

passing a first elongate member coupled to the urethral support through the incision in the vaginal wall, around a first side of the urethra and through tissue of a retro-pubic space on a first path behind a pubic bone, and through a rectus sheath and a surface of abdominal skin arriving at a first abdominal location;

passing a second elongate member coupled to the urethral support through the incision in the vaginal wall, around a second side of the urethra and through tissue of the retro-pubic space on a second path behind the pubic bone, and through the rectus sheath and the surface of abdominal skin arriving at a second abdominal location;

locating the urethral support under the urethra;

coupling a rotary force tensioner to at least one of the first elongate member and the second elongate member; and

applying tension to the at least one of the first elongate member and the second elongate member with the rotary force tensioner and adjusting tension of the urethral support.

2. The method of claim 1, comprising post-operatively adjusting tension of the urethral support one day after implantation of the urethral support.

3. The method of claim 1, comprising post-operatively adjusting tension of the urethral support 72 hours after implantation of the urethral support.

4. The method of claim 1, where the rotary force tensioner includes a wheel engaged with a wheel ratchet, the method further comprising:

engaging the at least one of the first elongate member and the second elongate member with the wheel; and

rotating the wheel relative to the wheel ratchet and imparting force to the at least one of the first elongate member and the second elongate member.

5. The method of claim 1, comprising locating the rotary force tensioner over the rectus sheath.

6. The method of claim 1, comprising sliding the at least one of the first elongate member and the second elongate member in one of two directions including a first direction from the urethral support toward the surface of abdominal skin and a second direction from the surface of abdominal skin toward the urethral support.

7. The method of claim 1, further comprising fine-tuning tension applied to the urethral support.

8. The method of claim 1, further comprising regulating tension applied to one of the first elongate member and the second elongate member.

9. The method of claim 1, comprising post-operatively adjusting tension of the urethral support by loosening one of the first elongate member and the second elongate member.

11. The method of claim 1, further comprising fine-tuning tension applied to the urethral support more than one day after implantation of the urethral support into the body of the patient.

12. The method of claim 1, comprising post-operatively adjusting tension to at least one of the first elongate member and the second elongate member after implantation of the urethral support into the body of the patient.

13. The method of claim 1, comprising manually turning the rotating wheel and applying tension to at least one of the first elongate member and the second elongate member.

10. A method for providing support to a urethra in treating urinary incontinence, the method comprising:

forming an incision in a vaginal wall, with the incision sized for introduction of a urethral support into a body of a patient;

passing a first elongate member coupled to the urethral support through the incision in the vaginal wall, around a first side of the urethra, and along a first path behind a pubic bone and through a rectus sheath and a surface of abdominal skin;

passing a second elongate member coupled to the urethral support through the incision in the vaginal wall, around a second side of the urethra, and along a second path behind the pubic bone and through the rectus sheath and the surface of abdominal skin;

positioning the urethral support under the urethra;

providing a rotary force tensioner having a rotating wheel and coupling one of the first elongate member and the second elongate member to the rotating wheel; and

turning the rotating wheel and applying tension to at least one of the first elongate member and the second elongate member.