Methods and apparatus for correction of urinary and gynecological pathologies, including treatment of male incontinence, and female cystocele

• US 20030023136A1
• Filed: 09/23/2002
• Published: 01/30/2003
• Est. Priority Date: 04/24/1998
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Ams Research Corporation (Endo International PLC)
• Inventors: Beyar, Mordechay, Globerman, Oren, Raz, Shlomo
• Granted Patent: US 6,691,711 B2
• Time in Patent Office: Days
• US Class Current: 600/29
• 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 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

The present invention relates to apparatus and methods for treatment of male incontinence and a method for female cystocele repair in which a sling material is positioned between the descending rami of the pubic bone. In such an operation a “hammock-like” sling material is positioned below the urethra in males, or below the posterior bladder wall in the case of cystocele in females.

Claims

1. A method for treatment of male incontinence comprising the steps of:

securing a sling material between the descending rami of the pubic bone by use of at least one bone anchor located in the pubic bone and locating said sling material below the urethra.

2. A method for treatment of male incontinence according to claim 1, wherein said sling material is synthetic material, autologous or cadaveric fascia.

3. A method for treatment of male incontinence according to claim 1 further comprising a step of positioning an inflatable device between said sling material and the urethra to provide desired compression of the urethra, said device being anchored to the right and left descending pubic rami.

4. A method for treatment of male incontinence according to claim 3 wherein said step of positioning an inflatable device further comprises the steps of inserting a needle percutaneously through the perineal area, inflating said inflatable device with fluid passing through said needle, and adjusting the volume and said desired compression of said inflatable device by selective inflation or reduction of the fluid inside said inflatable device.

5. A method for treatment of male incontinence according to claim 3 wherein said sling material is a component of said inflatable device.

6. A method for treatment of male incontinence according to claim 3 wherein said sling material and said inflatable device are an integral unit.

7. A method for treatment of male incontinence according to claim 1, further comprising the step of measuring urethral resistance and adjusting the tension of said sling material to obtain a desired level of urethral resistance.

8. A method for female cystocele repair comprising the steps of:

securing a sling material between the descending rami of the pubic bone by use of at least one bone anchor located in the pubic bone and locating said sling material below the posterior bladder wall.

9. A method for female cystocele repair according to claim 8, wherein said sling material is synthetic material, autologous or cadaveric fascia.

10. A method for female cystocele repair according to claim 8, wherein said sling material is located between the pubic bone and the descending pubic bone rami.

11. A method for female cystocele repair according to claim 8, wherein said step of secuing said sling material by use of at least one of said bone anchors located in the pubic bone further comprises the steps of:

threading each of said anchors with suture,

loading said anchor onto an inserter device,

palpating a ligament with a finger to locate a desired location for said anchor,

advancing said inserter device with said anchor along the finger until a tip of said anchor perforates said ligament,

deploying said anchor from said inserter device into said ligament so that said anchor firmly attaches to the ligament, and

removing said inserter device.

12. A method for female cystocele repair as claimed in claim 11 wherein said inserter device is used pervaginally.