Bladder neck suspension procedure
First Claim
1. A method of suspending a bladder neck, comprising the steps of:
- (a) securing a first suture to a first bone anchor;
(b) positioning said first anchor in a bone without exposing the bone by way of an open surgical procedure;
(c) advancing said first suture through a tissue generally adjacent to the bladder neck;
(d) providing a first suture support;
(e) securing said first suture to said first suture support;
(f) positioning said first suture support against the tissue generally adjacent to the bladder neck to increase the effective contact area between said first suture and the tissue; and
(g) suspending the bladder neck with said first suture.
2 Assignments
0 Petitions
Accused Products
Abstract
The surgical treatment of stress urinary incontinence is disclosed. The disclosed methods include: 1) a technique of probe passage to avoid injuring the bladder and to provide a more accurate and reproducible capture of the pubocervical fascia lateral to the bladder neck and urethra, 2) anchor fixation of the suspending sutures to the pubic bone to decrease the risk of suture pull through from above and to decrease post-operative pain and 3) a simple and reproducible technique to set a limited tension of the suspending sutures. A description of these methods and results of procedures with some of these methods are disclosed. Novel drill guides, suture passers, suture tensioners, and various related tools and devices for use in the surgical method are also disclosed.
572 Citations
51 Claims
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1. A method of suspending a bladder neck, comprising the steps of:
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(a) securing a first suture to a first bone anchor; (b) positioning said first anchor in a bone without exposing the bone by way of an open surgical procedure; (c) advancing said first suture through a tissue generally adjacent to the bladder neck; (d) providing a first suture support; (e) securing said first suture to said first suture support; (f) positioning said first suture support against the tissue generally adjacent to the bladder neck to increase the effective contact area between said first suture and the tissue; and (g) suspending the bladder neck with said first suture. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A method of suspending a bladder neck in a patient, said method comprising the steps of:
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(a) securing a first suture to a first bone anchor, said first suture having a first end and a second end; (b) positioning said first anchor in a pubic bone; (c) grasping said first suture with a probe, said probe being able to pierce tissue; (d) advancing said probe and the first end of said first suture behind the pubic bone and through an endopelvic fascia generally adjacent to a urethra at a first point; (e) releasing said first suture within a vaginal cavity; (f) withdrawing said probe through the endopelvic fascia; (g) advancing said probe through the endopelvic fascia at a second point, said second point also being generally adjacent to the urethra; (h) grasping said first suture within the vaginal cavity with said probe; (i) withdrawing said probe and said first end of said first suture through the endopelvic fascia; (j) releasing said first suture from said probe; and (k) tying the first and second ends of said first suture to suspend the bladder neck. - View Dependent Claims (15, 16, 17)
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18. A method of suspending a bladder neck from a bone while minimizing invasion of tissue generally adjacent to the bone, comprising the steps of:
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locating an anchoring site on the bone without exposing the bone in an open surgical procedure; advancing an anchor into the bone through the tissue generally adjacent to the bone; securing the anchor within the bone; and
thereaftersuspending the bladder neck using the anchor. - View Dependent Claims (19, 20, 21, 22, 23, 24)
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25. A method of suspending a bladder neck, comprising the steps of:
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(a) securing a first suture to a first bone anchor; (b) locating an anchoring site on a bone without exposing the bone; (c) positioning said first anchor in the bone; (d) advancing said first suture through a tissue generally adjacent to the bladder neck; (e) providing a first suture support; (f) securing said first suture to said first suture support; (g) positioning said first suture support against the tissue generally adjacent to the bladder neck to increase the effective contact area between said first suture and the tissue; and (h) suspending the bladder neck with said first suture. - View Dependent Claims (26, 27)
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28. A method of suspending a bladder neck from a bone while minimizing invasion of tissue generally adjacent to the bone, comprising the steps of:
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locating an anchoring site on the bone without exposing the bone; advancing an anchor into the bone through the tissue generally adjacent to the bone; securing the anchor within the bone; and
thereaftersuspending the bladder neck using the anchor. - View Dependent Claims (29, 30, 31, 32)
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33. A method of suspending a bladder neck comprising the steps of:
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securing a suture to a bone anchor; positioning said anchor in a bone without exposing the bone by way of an open surgical procedure; positioning a suture support secured to said suture against the tissue generally adjacent to the bladder neck to increase the effective contact area between said suture and the tissue; and suspending the bladder neck with said suture. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45)
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46. A method of suspending a bladder neck comprising the steps of:
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securing a suture to a bone anchor; positioning said anchor in a bone without exposing the bone; positioning a suture support secured to said suture against the tissue generally adjacent to the bladder neck to increase the effective contact area between said suture and the tissue; and suspending the bladder neck with said suture. - View Dependent Claims (47, 48, 49, 50, 51)
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Specification