Distensible sling for urinary incontinence

• US 6,786,861 B1
• Filed: 05/18/2001
• Issued: 09/07/2004
• Est. Priority Date: 10/01/1998
• Status: Expired due to Fees

• Current Assignee: Adam Jacobus Von Wielligh, Johannes Jacobus Pretorius, Nicolaas Daniel Lombard Burger, Rudolf Werner Ottermann
• Original Assignee: Adam Jacobus Von Wielligh, Johannes Jacobus Pretorius, Nicolaas Daniel Lombard Burger, Rudolf Werner Ottermann
• Inventors: Pretorius, Johannes Jacobus
• Primary Examiner(s): Gilbert, Samuel G
• Application Number:
  US09/806,656
• Time in Patent Office: 1,208 Days
• Field of Search: 600/29-31, 600/37, 128/DIG.25
• US Class Current: 600/31
• CPC Class Codes: A61F 2/0036 implantable A61F2/0018 takes precedence
• CPC Class Codes: A61F 2/004 inflatable

Abstract

The invention provides a sling prosthesis (10) for urinary incontinence and also a method of treating urinary incontinence. The sling (10) has a flexible elongate member (12) and a distensible portion (14) and is configured to be inserted dorsally between the urethra and pelvic bone, with ends of the elongate member attachable to retropubic or ischial structures. A valve (18) which is subcutaneously implantable in a labial or scrotal region may be connected via a conduit (16) to the dispensible portion. Fluid is injected via the valve into the distensible portion (14) to that the distensible portion (14) sufficiently constricts the urethra to inhibit undesirable leakage of urine. Fluid can then either be injected into or extracted from the distensible portion in order to alter distension thereof.

Claims

1. A urinary incontinence prosthesis including:

a flexible elongate member which is configured to extend between left and right retropubic or ischial structures of a patient when the ends of the elongate member are secured to the respective retropubic or ischial structure; and

a distensible portion which is positioned on the elongate member so that in use the distensible portion presses on one side of the urethra so as to apply a pressure sufficient to close the urethra and inhibit unintended passage of urine through the urethra,

wherein the prosthesis is configured to form an inverted sling when inserted between the urethra and pelvic bone and the ends of the elongate member are attached to the retropubic or ischial sutures.

2. A prosthesis as claimed in claim 1, wherein distension of the distensible portion is alterable.

3. A prosthesis as claimed in claim 1, which further includes a conduit in flow communication with the distensible portion;

and

a value means connected to an end of the conduit remote from the distensible portion, the valve means being in flow communication with the conduit and therefore also with the distensible portion.

4. A prosthesis as claimed in claim 3, wherein at least one longitudinal ridge is located along at least a portion of the length of an inner surface of the conduit.

5. A prosthesis as claimed in claim 3, wherein at least one spiral ridge runs along the length of an inner surface of the conduit.

6. A prosthesis as claimed in claim 3, wherein the valve means is sized and configured to permit subcutaneous implantation thereof in a labial region.

7. A prosthesis as claimed in claim 3, wherein the valve means is sized and configured to permit subcutaneous implantation thereof in a scrotum.

8. A prosthesis as claimed in claim 1, wherein at least one ridge is located on an inner surface of the distensible portion.

9. A method for surgically treating urinary incontinence, the method including the following step:

securing one end of a flexible elongate member of a prosthesis to a left retropubic or ischial structure of a patient and securing another end of the elongate member to a right retropubic or ischial structure so that a distensible portion of the prosthesis positioned on the elongate member is in contact with one side of the urethra of the patient at least when the distensible portion is distended wherein the prosthesis is positioned above the urethra to form a slink.

10. A method as claimed in claim 9, wherein the prosthesis is positioned between the urethra and pelvic bone such that the prosthesis forms an inverted sling above the urethra.

11. A method as claimed in claim 9, wherein the urethra is positioned between the prosthesis and pelvic bone such that the prosthesis, when distended, pinches the urethra between the prosthesis and the pelvic bone thereby to inhibit flow through the urethra.

12. A method as claimed in claim 10, which further includes the step of distending the distensible portion so that sufficient pressure is applied to the urethra so as to close the urethra and inhibit unintended passage of urine through the urethra.

13. A method as claimed in claim 11, which further includes the step of distending the distensible portion so that sufficient pressure is applied to the urethra so as to close the urethra and inhibit unintended passage of urine through the urethra.

14. A method as claimed in claim 12, wherein the pressure applied by the prosthesis to the urethra is adjustable by adjusting the distension of the distensible portion by either injecting fluid into or extracting fluid from the distensible portion through a valve which is subcutaneously implanted into a scrotum or labial region and which is in flow communication with the distensible portion.

15. A method as claimed in claim 13, wherein the pressure applied by the prosthesis to the urethra is adjustable by adjusting the distension of the distensible portion by either injecting fluid into or extracting fluid from the distensible portion through a valve which is subcutaneously implanted into a scrotum or labial region and which is in flow communication with the distensible portion.