JP2010017540A - Artificial sphincter muscle - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an artificial sphincter muscle, acting for the function of a urethra sphincter muscle without excessively pressing the urethra. <P>SOLUTION: The artificial sphincter muscle acting for the function for a urethra sphincter muscle is provided with a urethra pressing part 11 to press the urethra 1, and a pressure providing part 12 to provide pressure to the urethra 1 through the urethra pressing part 11. The urethra pressing part 11 is formed like a sheet having such length that it can be installed around the urethra 1. The pressure providing part 12 comprises a magnet case 13 to be embedded in the patient's body close to the urethra, a body side permanent magnet 14 to be movably housed in the magnet case 13, a connection member 15 to connect the body side permanent magnet 14 to the urethra pressing part 11, and a soft magnetic material 16 to attract the body side permanent magnet 14 toward one end side of the magnet case 13 for providing tension to the connection member 15. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an artificial sphincter used as a means for preventing urinary incontinence due to dysfunction of the urethral sphincter.

  As a treatment method for preventing urinary incontinence due to dysfunction of the urethral sphincter, there is a treatment method for preventing urinary incontinence by implanting an artificial sphincter into the body. Artificial sphincter used for this treatment is known to substitute for the function of the urethral sphincter by supplying liquid to the cuff placed around the urethra or draining liquid from the cuff. (See Patent Document 1).

  However, the artificial sphincter described above requires a pump for supplying liquid to the cuff, a reservoir ring for storing the liquid discharged from the cuff, and the like. For this reason, a structure enlarges and there exists a difficulty that it is not suitable for a patient with a small body. In addition, since it is necessary to embed a pump and a reservoir ring in the body, there is also a drawback that surgery becomes large. Furthermore, since it is necessary to embed a battery for operating the pump in the body, there is a difficulty in that an operation for battery replacement must be performed about once a year.

  Therefore, in order to solve such a problem, the present inventors have devised an artificial sphincter as shown in FIG. 12 (see Patent Document 2). This artificial sphincter is of a type that presses against the urethra 1 by means of an iron plate 3 and an internal magnet 4 that are arranged facing the inside of a frame 2 that surrounds the urethra 1. The structure is such that the compression force on the urethra 1 is released by bringing the external magnet 7 outside the body closer to the connected movement auxiliary magnet 6.

Japanese Examined Patent Publication No. 6-38808 JP 2007-282923 A

The artificial sphincter shown in FIG. 12 does not require a pump, a reservoir ring, a battery or the like to be embedded in the body unlike the one disclosed in Patent Document 1, and thus has an advantage that it can be applied to a patient with a small body. ing. However, since the urethra is pressed by pressing it with an iron plate and a permanent magnet, an excessive pressing force may be applied to the urethra.
The present invention has been made in view of the above problems, and an object of the present invention is to provide an artificial sphincter that can substitute the function of the urethral sphincter without excessively pressing the urethra.

In order to solve the above-described problem, an artificial sphincter according to claim 1 of the present invention includes an artificial urethra compression part that compresses the urethra, and a compression force applying part that applies a compression force to the urethra via the urethra compression part. It is a sphincter, wherein the urethral compression part has a length that can be mounted around the urethra and is formed in a sheet shape.
An artificial sphincter according to a second aspect of the present invention is the artificial sphincter according to the first aspect, wherein the compression force applying portion is accommodated in a magnet case embedded in the body near the urethra, and is movably accommodated in the magnet case. A body-like permanent magnet, a string-like or belt-like connecting member that connects the body-internal permanent magnet and the urethral compression portion, and the body-internal permanent magnet is drawn toward one end side of the magnet case to tension the connecting member. And a soft magnetic material to be imparted.

The artificial sphincter of the invention according to claim 3 is the artificial sphincter according to claim 2, wherein the urethral compression part is a urethral wrapping film that wraps around the urethra, a sheet-like cover that covers the back surface of the urethral wrapping film, A net-like compression member extending in the circumferential direction of the urethra and disposed between the urethral wrapping film and the sheet-like cover,
One end of the mesh-like compression member is connected to the body-internal permanent magnet through the connection member.

  The artificial sphincter of the invention according to claim 4 is the artificial sphincter according to claim 2, wherein the urethral compression part is a urethral wrapping film that wraps around the urethra, a sheet-like cover that covers the back surface of the urethral wrapping film, An interposed sheet interposed between the urethral wrapping film and the sheet-like cover and forming a compression member arrangement space continuous in the circumferential direction of the urethra, extending in the circumferential direction of the urethra, and A linear compression member disposed inside the compression member arrangement space,

One end of the linear compression member is connected to the body-internal permanent magnet through the connection member.
The artificial sphincter according to a fifth aspect of the present invention is the artificial sphincter according to any one of the second to fourth aspects, wherein the compression force applying portion is a tube-shaped cover member that covers the connecting member. And the magnet case.

According to the artificial sphincter of the invention according to claim 1, there is no possibility of applying an excessive pressing force to the urethra as in the case of the method of pinching the urethra with an iron plate and a permanent magnet, so that the urethra is not excessively compressed. Can act as a function of the urethral sphincter.
According to the artificial sphincter of the invention according to claim 2, since it is not necessary to embed a pump, a reservoir ring, a battery, or the like in the body, it can be applied to a patient with a small body and without requiring maintenance such as battery replacement. Can act as a function of the urethral sphincter.

According to the artificial sphincter of the invention according to claim 3, since the tension applied to the connecting member is transmitted to the mesh-like compression member as the urethral compression force, the urethra can be reliably compressed.
According to the artificial sphincter of the invention according to claim 4, the tension applied to the connecting member is transmitted to the linear compression member as the urethral compression force, so that the urethra can be reliably compressed.
According to the artificial sphincter of the invention according to claim 5, since the connecting member does not come into contact with the body tissue, the connecting member adheres to the body tissue to compress the urethra or release the compression force applied to the urethra. It can be prevented that it becomes impossible.

It is a figure which shows schematic structure of the artificial sphincter muscle which concerns on 1st embodiment. It is a top view of the urethral compression part of the artificial sphincter according to the first embodiment. It is a figure which shows the AA cross section of FIG. It is a figure which shows the state which compressed the urethra with the artificial sphincter which concerns on 1st embodiment. It is a figure which shows the state which cancelled | released the compression force added to the urethra. It is a top view of the urethral compression part of the artificial sphincter according to the second embodiment. It is a figure which shows the AA cross section of FIG. It is a figure which shows the operation | movement principle in the normal time of the artificial sphincter which concerns on 2nd embodiment. It is a figure which shows the state which compressed the urethra with the artificial sphincter which concerns on 2nd embodiment. It is a figure which shows the operation | movement principle at the time of urination of the artificial sphincter muscle which concerns on 2nd embodiment. It is a figure which shows the state which cancelled | released the compression force added to the urethra. It is a figure which shows an example of the conventional artificial sphincter.

(First embodiment)
Hereinafter, an embodiment of the present invention (hereinafter referred to as “first embodiment”) will be described with reference to FIGS.
As shown in FIG. 1, the artificial sphincter according to the first embodiment includes a urethra compression unit 11 that compresses the urethra 1, and a compression force application unit 12 that applies a compression force to the urethra 1 through the urethra compression unit 11. It is configured with.

  Here, the compression force application unit 12 has a plastic magnet case 13 embedded in the body in the vicinity of the urethra 1, and a cylindrical body-internal permanent magnet 14 moves inside the magnet case 13. Contained as possible. In addition, the compression force applying unit 12 includes a connecting member 15 that connects the inner permanent magnet 14 and the urethral pressing unit 11, and the connecting member 15 is formed in a string shape using nylon or the like as a material. Yes. In addition, although 1st embodiment demonstrates the case where the connection member 15 is formed in string shape, the structure of the connection member 15 is not limited to this, You may form in strip | belt shape.

The compression force applying unit 12 includes a soft magnetic body 16 that pulls the inner permanent magnet 14 toward one end side of the magnet case 13 (one end side opposite to the urethral compression unit 11) to apply tension to the connecting member 15. is doing. The soft magnetic body 16 is formed of an iron plate or the like.
Further, the compression force applying unit 12 includes a tube-shaped cover member 17 that covers the connecting member 15 between the urethral compression unit 11 and the magnet case 13, and the tube-shaped cover member 17 is a medical grade silicone rubber. It is formed of an elastic material such as.

As shown in FIG. 2, the urethral compression part 11 is formed in a sheet shape having a length that can be mounted around the urethra 1, and the urethral compression part 11 is disposed around the urethra 1 at the front end thereof. Therefore, a pair of left and right projecting pieces 18 a and 18 b that are fastened by a fastening method such as sewing are formed at the rear end of the urethral compression portion 11.
2 and 3, the urethral compression part 11 has a urethral wrap film 19 that wraps around the urethra 1 and a sheet-like cover 20 that covers the back surface of the urethra wrap film 19, The urethral wrap film 19 and the sheet-like cover 20 are formed of a material that is difficult to adhere to a body tissue (for example, polyester).

In addition, the urethral compression portion 11 includes a mesh-like compression member 21 that extends in the circumferential direction of the urethra 1 and is disposed between the urethra wrap film 19 and the sheet cover 20. The net-like compression member 21 is made of nylon or the like and has flexibility.
Further, one end of the mesh-like compression member 21 is connected to the body inner permanent magnet 14 through the connecting member 15.

On the other hand, the other end of the mesh-like compression member 21 is interposed between the urethra wrap film 19 and the sheet cover 20 and is fixed to the urethra wrap film 19 and the sheet cover 20 by adhesion or the like.
Therefore, at normal times, as shown in FIG. 4, when tension is applied to the connecting member 15 by attracting the inner permanent magnet 14 to the soft magnetic body 16, the tension applied to the connecting member 15 is reduced by urethral compression. The force is transmitted to the mesh-like compression member 21 of the urethral compression part 11 as force. As a result, the mesh-like compression member 21 slides against the urethra wrap film 19 and the sheet-like cover 20, the inner diameter of the urethra compression part 11 wound around the urethra 1 is reduced, and the urethra 1 is compressed from the surroundings. It has become so.

On the other hand, when urinating, as shown in FIG. 5, the external permanent magnet 22 is brought close to the soft magnetic body 16, and the internal permanent magnet is generated by the repulsive force generated between the internal permanent magnet 14 and the external permanent magnet 22. When 14 moves in a direction away from the soft magnetic body 16, the inner diameter of the urethral compression portion 11 wound around the urethra 1 increases, and the compression force applied to the urethra 1 by the urethral compression portion 11 is released. It has become.
In the artificial sphincter according to the first embodiment described above, the urethra compression part 11 has a length that can be attached to the periphery of the urethra 1 and is formed in a sheet shape, so that the urethra is pinched by a permanent magnet and an iron plate. Unlike an artificial sphincter of a system, there is no possibility of applying an excessive compression force to the urethra 1. Therefore, the function of the urethral sphincter can be substituted without excessively pressing the urethra 1.

Moreover, it becomes possible to reduce the damage which arises in the urethra 1 by the string-shaped member compared with the structure which presses the urethra 1 from the circumference.
In addition, since the urethra 1 can be compressed from the periphery by the urethra compression part 11 wound around the urethra 1, for example, it is necessary to fix a member that presses the urethra 1 from the periphery to a body tissue such as a bone. There is no. For this reason, it becomes possible to reduce the effort and danger at the time of implanting an artificial sphincter in the body.

  Also, a magnet case 13 embedded in the body in the vicinity of the urethra, and a body-internal permanent magnet movably accommodated in the magnet case 13, which applies a compressive force to the urethra 1 via the urethra pressure part 11. 14, a connecting member 15 that connects the body-internal permanent magnet 14 and the urethral compression portion 11, and a soft magnetic body 16 that pulls the body-internal permanent magnet 14 toward one end of the magnet case 13 and applies tension to the connecting member 15. Therefore, unlike the one disclosed in Patent Document 1, it is not necessary to embed a pump, a reservoir ring, a battery, or the like in the body. Therefore, the present invention can be applied to a patient with a small body, and the function of the urethral sphincter can be substituted without requiring maintenance such as battery replacement.

Further, the net-like compression member 21 having one end connected to the body inner permanent magnet 14 via the connection member 15 is disposed between the urethra-wrapping film 19 and the sheet-like cover 20 of the urethra compression part 11, thereby connecting Since the tension applied to the member 15 is transmitted to the mesh-like compression member 21 as a urethral compression force, the urethra 1 can be reliably compressed.
In addition, since the tubular cover member 17 that covers the connecting member 15 is provided between the urethral compression portion 11 and the magnet case 13, the connecting member 15 does not come into contact with the body tissue. It is possible to prevent the urethra 1 from being compressed or the pressure applied to the urethra 1 from being released due to adhesion to the urethra.
In addition, the urethral wrapping film 19 of the urethral compression portion 11 is formed of a material that does not easily adhere to the body tissue, so that the urethral compression portion 11 can be prevented from adhering to the urethra 1.

(Second embodiment)
Next, another embodiment of the present invention (hereinafter referred to as “second embodiment”) will be described with reference to FIGS.
The configuration of the artificial sphincter muscle of the second embodiment is the same as that of the first embodiment described above (see FIG. 1) except for the configuration of the urethral compression portion 11, so the following description will focus on the portion related to the urethral compression portion 11. It describes.
That is, the urethral compression portion 11 provided in the artificial sphincter of the second embodiment is formed in a sheet shape having a length that can be mounted around the urethra 1 as shown in FIG. In order to wrap the urethral compression part 11 around the urethra 1, a pair of left and right projecting pieces 18 a and 18 b that are fastened by a fastening method such as sewing are formed at the rear end of the urethral pressure part 11. .

As shown in FIGS. 6 and 7, the urethral compression unit 11 includes a urethral wrapping film 19 that wraps around the urethra 1, a sheet-like cover 20 that covers the back surface of the urethral wrapping film 19, and an intervening sheet 23. The linear compression member 24 is provided.
The thickness of the urethral wrapping film 19 is formed to be thinner than the thickness of the sheet-like cover 20. Thereby, the urethral wrapping film 19 is configured to bend more easily than the sheet-like cover 20. For example, the thickness of the urethral wrapping film 19 and the thickness of the sheet-like cover 20 are the same, and the material of the urethral wrapping film 19 is a material having a lower strength than the material of the sheet-like cover 20. However, it is good also as a structure which curves more easily than the sheet-like cover 20. FIG.

Like the urethra wrap film 19 and the sheet-like cover 20, the intervention sheet 23 is formed of a material (for example, polyester) that does not easily adhere to the body tissue. In addition, 2nd embodiment demonstrates the case where the intervention sheet | seat 23 is formed from the four strip | belt-shaped members continuous in the circumferential direction of the urethra 1. FIG. However, the configuration of the interposed sheet 23 is not limited to this, and may be formed from a single band-shaped member.
The intervention sheet 23 is interposed between the urethra wrap film 19 and the sheet cover 20 and attached to the urethra wrap film 19 and the sheet cover 20.

  In addition, a compression member disposition space 25 that is continuous in the circumferential direction of the urethra 1 is formed in the intervention sheet 23. In the second embodiment, as an example, a case where three rows of compression member arrangement spaces 25 parallel to each other are formed in the interposed sheet 23 will be described, but the configuration of the interposed sheet 23 is limited to this. Not what you want. That is, for example, two or more rows of compression member arrangement spaces 25 that are parallel to each other may be formed in the interposed sheet 23, or only one row of compression member arrangement spaces 25 may be formed. .

Specifically, the three rows of the compression member arrangement spaces 25 have four belt-like members forming the interposed sheet 23 between the urethral wrapping film 19 and the sheet-like cover 20 in a state of being spaced apart from each other. It is formed by interposing and attaching to the urethral wrapping film 19 and the sheet-like cover 20. In the case where the intervention sheet 23 is formed from a single belt-like member, the intervention sheet 23 may be processed to form a compression member arrangement space 25 that is continuous in the circumferential direction of the urethra 1.
The linear compression member 24 is a linear member that extends in the circumferential direction of the urethra, is formed of nylon or the like, and has flexibility.
The linear compression member 24 is disposed inside the compression member arrangement space 25. In the second embodiment, as an example, when the linear compression members 24 are respectively formed in the three rows of compression member arrangement spaces 25, that is, the urethral compression portion 11 has three linear shapes. A case where the compression member 24 is provided will be described.

In the second embodiment, as an example, the urethral wrapping film side recess 19a in which a part of the linear compression member 24 can be disposed is formed in a portion of the urethral wrapping film 19 that faces the compression member disposition space 25. The case will be described. However, the configuration of the urethral wrapping film 19 is not limited to this, and the urethral wrapping film side recess 19a may not be formed in the urethral wrapping film 19.
One end portion of the linear compression member 24 is connected to the body inner permanent magnet 14 via the connecting member 15.

On the other hand, the other end of the linear compression member 24 is fixed to the urethral wrapping film 19, the sheet-like cover 20, and the interposition sheet 23 by adhesion or the like.
Therefore, at normal times, as shown in FIG. 8, when tension is applied to the connecting member 15 by attracting the inner permanent magnet 14 to the soft magnetic body 16, the tension applied to the connecting member 15 is reduced by urethral compression. The force is transmitted to the linear compression member 24 of the urethral compression portion 11 as force. In FIG. 8, the other end portion of the linear compression member 24 indicates a fixed end that is fixed to the urethral wrapping film 19, the sheet-like cover 20, and the interposition sheet 23 with a reference numeral 26. .

When the tension applied to the connecting member 15 is transmitted to the linear compression member 24, the length of the linear compression member 24 in the compression member arrangement space 25 is shortened, and the linear compression member is applied to the urethral wrapping film 19. 24 slides, the urethra wrapping film 19 side is more greatly curved than the sheet-like cover 20 side, and the urethral compression part 11 is curved.
When the urethra wrap film 19 side is curved more than the sheet cover 20 side, as shown in FIG. 9, the inner diameter of the urethra compression portion 11 wound around the urethra 1 is reduced, so that the urethra 1 is compressed from the surroundings. It has become.

On the other hand, when urinating, as shown in FIG. 10, the external permanent magnet 22 is brought close to the soft magnetic body 16, and the internal permanent magnet is generated by the repulsive force generated between the internal permanent magnet 14 and the external permanent magnet 22. 14 moves in a direction away from the soft magnetic body 16. In FIG. 9, as in FIG. 8, the other end of the linear compression member 24 has a fixed end 26 attached to the urethral wrap film 19, the sheet cover 20, and the interposition sheet 23. As shown.
When the body inner permanent magnet 14 moves away from the soft magnetic body 16, the length of the linear compression member 24 in the compression member arrangement space 25 increases, and the curvature of the urethral wrap film 19 is determined by the sheet-like cover 20. Is substantially the same as the degree of curvature.

When the degree of curvature of the urethra wrap film 19 is substantially the same as the degree of curvature of the sheet cover 20, the inner diameter of the urethra compression part 11 wound around the urethra 1 increases as shown in FIG. 11, the pressure applied to the urethra 1 is released.
The artificial sphincter according to the second embodiment described above includes a compression member arrangement space 25 in which a linear compression member 24 having one end connected to the body inner permanent magnet 14 via the connection member 15 is formed on the interposed sheet 23. Since the tension applied to the connecting member 15 is transmitted to the linear compression member 24 as a urethral compression force due to the arrangement inside, the urethra 1 can be reliably compressed.

In addition, since the linear compression member 24, that is, a linear member extending in the circumferential direction of the urethra, can constitute a member that compresses the urethra 1, as in the first embodiment described above, Compared to the case where a member that compresses the urethra 1 is formed by a net-like member formed by knitting vertical cords and horizontal cords, a member that compresses the urethra 1 can be easily created.
In addition, since a plurality of linear compression members 24 are arranged inside a plurality of rows of compression member arrangement spaces 25 that are parallel to each other, the linear compression members 24 can be prevented from being entangled with each other, and operation stability can be prevented. As a result, it is possible to improve durability.

  Further, since the intervening sheet 23 is interposed between the urethral wrapping film 19 and the sheet-like cover 20 and attached to the urethral wrapping film 19 and the sheet-like cover 20, the durability and reliability of the urethral compression portion 11 are ensured. It becomes possible to improve the property. Thereby, compared with the first embodiment described above, it is possible to suppress the intrusion of the liquid into the urethral compression part 11 and the urethral compression part 11 when the liquid enters the urethral compression part 11. It becomes possible to reduce damage.

Reference Signs List 1 urethra 2 frame 3 iron plate 4 internal magnet 5 continuous rod 6 movement auxiliary magnet 7 external magnet 11 urethral compression part 12 compression force applying part 13 magnet case 14 body inner permanent magnet 15 connecting member 16 soft magnetic body 17 tubular cover member 18a, 18b Projection piece 19 Urethral wrapping film 20 Sheet-shaped cover 21 Reticulated compression member 22 Body outer permanent magnet 23 Interposition sheet 24 Linear compression member 25 Compression member arrangement space 26 Fixed end

Claims (5)

  An artificial sphincter comprising: a urethral compression portion that compresses the urethra; and a compression force applying portion that applies a compression force to the urethra through the urethral compression portion, and the urethral compression portion can be attached around the urethra An artificial sphincter characterized by being formed into a sheet shape with a thickness.   The compression force application unit connects a magnet case embedded in a body near the urethra, a body-internal permanent magnet movably accommodated in the magnet case, and the body-internal permanent magnet and the urethra compression unit. The artificial member according to claim 1, further comprising: a string-shaped or belt-shaped coupling member; and a soft magnetic body that pulls the inner permanent magnet toward one end of the magnet case to apply tension to the coupling member. sphincter. The urethral compression part includes a urethral wrapping film that wraps around the urethra, a sheet-like cover that covers a back surface of the urethral wrapping film, and extends in a circumferential direction of the urethra, and the urethral wrapping film and the sheet-like cover A reciprocal compression member disposed between and
The artificial sphincter according to claim 2, wherein one end of the mesh-like compression member is connected to the body inner permanent magnet through the connection member. The urethral compression part is interposed between the urethra wrap film surrounding the urethra, a sheet-like cover covering the back surface of the urethra wrap film, the urethral wrap film and the sheet-like cover, and the urethra An interposition sheet that forms a compression member arrangement space that is continuous in the circumferential direction, and a linear compression member that extends in the circumferential direction of the urethra and is arranged inside the compression member arrangement space,
The artificial sphincter according to claim 2, wherein one end of the linear compression member is connected to the body inner permanent magnet through the connection member.   5. The artificial body according to claim 2, wherein the compression force applying unit includes a tubular cover member that covers the connecting member between the urethral compression unit and the magnet case. sphincter.

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