Endopelvic fascia treatment for incontinence
First Claim
1. A method for treating incontinence, the method comprising reducing an elasticity of a pelvic support tissue system along a length of the tissue sufficiently so that the tissue inhibits incontinence, wherein the tissue is loaded along the length under an incontinence-event stress pulse, and wherein the elasticity of the tissue is reduced without significantly reducing the length.
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Accused Products
Abstract
Methods, devices, and systems for treating the support structures of the body, particularly for incontinence, take advantage of two mechanisms to enhance the support provided by the fascia, ligaments and tendons: first, the invention increases a modulus of elasticity of these tissues, and particularly of the fascial tissues. The increase in modulus can be effected by directing sufficient energy to the fascial tissue so as to promote the formation of scar tissue. The second mechanism attaches tissue planes together, often by directing energy to an interface between adjacent fascial tissues.
441 Citations
25 Claims
- 1. A method for treating incontinence, the method comprising reducing an elasticity of a pelvic support tissue system along a length of the tissue sufficiently so that the tissue inhibits incontinence, wherein the tissue is loaded along the length under an incontinence-event stress pulse, and wherein the elasticity of the tissue is reduced without significantly reducing the length.
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10. A method for treating incontinence, the method comprising:
reducing an elasticity of a pelvic support tissue system, the tissue system comprising a fascial tissue supporting the urethra or bladder, by promoting scarring of the fascial tissue, the scarring increasing a modulus of elasticity of the fascial tissue without significantly shrinking the fascial tissue and the tissue system so that the fascial tissue and the tissue system inhibit incontinence, wherein the elasticity is reduced as a result of delivering energy to the fascial tissue so as the heat the fascial tissue to a temperature in a range from 45 to below 60°
C.
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11. A method for treating incontinence, the method comprising:
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reducing an elasticity of a pelvic support tissue system sufficiently so that the tissue system inhibits incontinence, wherein the elasticity is reduced, without significantly shrinking the tissue system, by directing energy into a fascial tissue of the tissue system so as to injure the fascial tissue without ablating the fascial tissue, and so as to promote scarring of the fascial tissue, the fascial tissue supporting a urethra or bladder, the scarring increasing a modulus of elasticity of the fascial tissue so that the fascial tissue inhibits incontinence, the directing energy step comprising transmitting RF current from at least one electrode to the fascial tissue; and
maintaining an intermediate tissue disposed between the electrode and the fascial tissue at a temperature lower than a treatment temperature of the fascial tissue by cooling the intermediate tissue with the electrode, wherein the electrode transmits the RF current via the cooled tissue to the fascial tissue. - View Dependent Claims (14, 23)
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12. A method for treating incontinence, the method comprising:
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reducing an elasticity of a pelvic support tissue system along a length of the tissue sufficiently so that the tissue inhibits incontinence, wherein the tissue is loaded along the length under an incontinence-event stress pulse, and comparing a change in urethral pressure relative to a change in vesicle pressure, and tailoring an incontinence therapy in response to the comparing step to maintain the urethral pressure above the vesicle pressure throughout the incontinence-event stress pulse.
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- 13. A method for treating incontinence, the method comprising promoting attachment between a first tissue and a second tissue with energy or an active agent, the second tissue slidingly engaging the first tissue prior to attachment so that the attachment limits motion between the first and second tissues and the limited motion inhibits incontinence.
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24. A method for treating incontinence, the method comprising:
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measuring a urethral pressure and a vesicle pressure during a stress;
comparing a change in the measured urethral pressure relative to a change in the measured vesicle pressure; and
reducing an elasticity of a pelvic support system in response to the comparing step sufficiently that the urethral pressure will remain greater than the vesicle pressure during stress.
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25. A system to treat incontinence, the system comprising:
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a probe for delivering energy or an active agent to a pelvic support tissue so as to reduce an elasticity of the pelvic support tissue;
a control system coupled to the probe, the control system limiting the delivery from the probe to avoid collateral damage;
a urethral pressure sensor;
a vescile pressure sensor; and
a processor coupled to the urethral pressure sensor and the vescile pressure sensor, the processor generating an output indicating a change in urethral pressure relative to a change in vesicle pressure.
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Specification