Adjustable Incontinence Apparatus

• US 20080269547A1
• Filed: 02/25/2008
• Published: 10/30/2008
• Est. Priority Date: 02/26/2007
• Status: Active Grant

• Current Assignee: Jay S. Hortenstine
• Original Assignee: Jay S. Hortenstine
• Inventors: Hortenstine, Jay S.
• Granted Patent: US 8,684,907 B2
• Time in Patent Office: Days
• US Class Current: 600/30
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

In an exemplary embodiment an adjustable urethral sling includes a flexible mesh support having a mesh envelope at a suburethral potion and an expansion chamber within the mesh envelope. A conduit may be provided that extends along the flexible mesh support and that is in fluid communication with the expansion chamber. When installed in a patient the sling may loop under the urethra and out exit sites. An access port may be provided in a subcutaneous pocket and attached to the conduit to allow for remote expansion of the expansion chamber from a desirable location to allow adjustment of the sling with the patient in a standing position. The mesh envelope allows tissue ingrowth around the container so that the container can be expanded for a long period of time after implantation. The expansion chamber may be U-shaped to provide lateral closing pressure to the urethra when expanded.

Claims

1. A urethral sling, comprising:

a flexible mesh support adapted for implantation into a body;

a collapsible mesh envelope located at a suburethral portion of the flexible mesh support; and

an expansion chamber housed within said collapsible mesh envelope.

2. The urethral sling of claim 1, wherein said mesh envelope comprises a two layer mesh.

3. The urethral sling of claim 1, wherein said flexible mesh support comprises a mesh tube.

4. The urethral sling of claim 1, further comprising:

a conduit in fluid communication with the expansion chamber, the conduit extending from the expansion chamber and following the flexible mesh support.

5. The urethral sling of claim 4, wherein said conduit is attached to said flexible mesh support.

6. The urethral sling of claim 1, wherein said expansion chamber comprises a plurality of expansion subchambers.

7. The urethral sling of claim 1, wherein said expansion chamber is configured to form a U-shaped cradle when expanded.

8. The urethral sling of claim 1, further comprising:

attachments means for attaching said mesh envelope to periurethral tissue.

9. The urethral sling of claim 1 wherein said collapsible mesh envelope is shaped to receive the expansion chamber in an expanded condition.

10. The urethral sling of claim 1, wherein:

said expansion chamber comprises a plurality of expansion subchambers; and

wherein said conduit comprises a first conduit in fluid communication with a first expansion subchamber and a second conduit in fluid communication with a second expansion subchamber.

11. A urethral sling system, comprising:

a flexible mesh support adapted for implantation into a body;

a collapsible mesh envelope located at a suburethral portion of the flexible mesh support;

an expansion chamber housed within the collapsible mesh envelope;

a conduit in fluid communication with the expansion chamber; and

an access port fluidly coupled to the conduit.

12. The urethral sling system of claim 11, wherein the access port is provided at a remote location from the expansion chamber.

13. The urethral sling system of claim 11, wherein the access port is positioned subcutaneously at a remote location from the expansion chamber.

14. The urethral sling system of claim 11, further comprising:

a second access port; and

a second conduit fluidly coupled to the expansion chamber and the second access port.

15. The urethral sling of claim 14, wherein said access port and said second access port have palpably different housings.

16. The urethral sling of claim 11, wherein said expansion chamber, comprises:

a center portion to provide support under the urethra;

a left outer portion to provide lateral support to the urethra when expanded; and

a right outer portion to provide lateral support when expanded.

17. The apparatus of claim 16, wherein:

a first conduit is in fluid communication with said center portion and a second conduit is in fluid communication with said left and right outer portions.

18. A method, comprising:

implanting a flexible mesh support within a patient, the flexible mesh support looping under the urethra so that an expansion chamber enclosed within a mesh envelope is positioned under the urethra, the expansion chamber in an initial collapsed condition.

19. The method of claim 18, further comprising:

wherein a conduit extends along the flexible mesh support and out an exit site and trimming the flexible mesh support and conduit to a desired size.

20. The method of claim 18, further comprising:

attaching the mesh envelope to periurethral tissue.

21. The method of claim 18, further comprising:

making a subcutaneous pouch at a remote location from the expansion chamber.

22. The method of claim 18, further comprising:

inserting an access port in a subcutaneous pocket remote from the expansion chamber.

23. The method of claim 22, further comprising:

fluidly coupling the access port to the conduit to form a flow path for expansion fluid between the access port and the expansion chamber.

24. The method of claim 23, further comprising:

injecting an expansion fluid into the access port to expand the expansion chamber.

25. The method of claim 24, wherein prior injecting an expansion fluid into the access port to expand the expansion chamber, the step of allowing tissue ingrowth to occur in the mesh envelope.