KR101007458B1 - Devices for treatment of urinary incontinence - Google Patents

Abstract

The present invention implants a tape to support the urethra in order to prevent the urinary function is not performed smoothly to prevent the discharge of urine irrespective of their will (urinary incontinence), both ends of the tape to the closed muscle of the pelvic cavity ( The present invention relates to an urinary incontinence treatment apparatus that is fixed to an obturator muscle or urogenital diaphragm to provide more stable support to the urethra and to perform surgery with a single incision.

The present invention for realizing this is to support the urethra in the human body with a tape, the fixing part is connected to each side of the tape in order to provide support to the tape, the fixing part in the obturator muscle, or urethral pelvic muscles in the human body By fixing each of the urogenital diaphragm to provide support to the tape, it is possible to shorten the time to perform the surgery without going through the process of sealing the body and the tape.

Incontinence care devices, incontinence, obstructive muscles

Description

Urinary Incontinence Devices {Devices for treatment of urinary incontinence}

The present invention relates to a female urinary incontinence surgical treatment apparatus, and more particularly, the urethral function is not performed smoothly, but the tape is implanted to support the urethra to prevent the discharge of urine regardless of their will, An incontinence treatment device that secures both ends of the tape to the obturator muscle or urogenital diaphragm of the pelvic cavity, respectively, to provide more stable support to the urethra and to perform surgery with a single incision. It is about.

Urinary incontinence refers to the discharge of urine in the bladder through the urethra regardless of his will. The prevalence of urinary incontinence in women aged 19 and over was 24.3% in the 2005 National Health and Nutrition Survey. Based on age prevalence and actual population, the estimated number of patients is estimated to be about 4.2 million women over 19 years of age. The average age of onset patients is in their late 30s. If these incontinences are severe, social activities may be restricted, giving up social activities or causing mental disorders such as depression.

Urinary incontinence is divided into stress urinary incontinence and urgency incontinence.

The lower urinary tract functions normally to facilitate the storage and discharge of urine. Among them, effective urinary storage requires that the pressure in the bladder be kept low while the urine is increased, the bladder outlet is kept closed, and this state can be maintained even when the pressure is increased.

In addition, involuntary bladder contractions should not occur during urinary storage. In case of abnormality in these factors, urinary incontinence occurs.

Stress urinary incontinence, which accounts for two thirds of all urinary incontinence, is caused by a weak bladder outlet or anatomical abnormalities in the urethra. The causes of stress urinary incontinence include pelvic muscles that support the bladder and urethra due to repeated pregnancy and childbirth, or surgery in the pelvic cavity (including radiation therapy), if the urinary resection force is weak due to deterioration or damage to the support base of the urethra itself. If the bladder neck and urethra sag down as the ligament ruptures and weakens, the nerves supporting the sphincter muscles are partially damaged during childbirth and the sphincter muscles fail to function and weaken and blood vessels in the urethra are contracted after menopause. Extremely weak.

On the other hand, urinary incontinence due to instability and overactivity of the bladder accounts for more than 50% of male urinary incontinence and 10-15% of young women. An overactive bladder is caused by sensitization of the bladder or urethra's afferent nerve endings, changes in secondary bladder muscles by denervation, or various central nervous system injuries such as multiple sclerosis, cerebrovascular disease, Parkinson's disease, and spinal cord injury. It can also be caused by changes in the brain and bladder due to aging.

Treatment for stress urinary incontinence includes medication, behavioral therapy such as pelvic floor muscle training, and surgical treatment, depending on the cause.

Some drugs use drugs, but no effective and safe drugs are available. Non-surgical methods are effective in treating severe symptoms, but the success rate is about 30%, and long-term continuous treatment can be effective. This is being preferred.

The most innovative surgical procedure for the treatment of urinary incontinence is the method of supporting the urethra by incision of the vaginal region by the procedure of the central urethral sling (posterior bone approach, closed-hole approach) using artificial materials to attract the tape-like material to the central urethra. to be.

However, in the posterior bone central urethral sling, there is a possibility of bladder injury, bowel injury, and vascular injury as the surgical instrument passes through the posterior bone, and death of some patients has been reported. Closed cavity midurethral slings can cause severe leg pain in some patients. In addition, the two methods have two skin incisions besides the vagina, causing the need to suture the skin.

The first object of the present invention for improving and solving the problems described above is to provide a constant support force to the urethra without the urinary incontinence tape completely penetrating the tissue.

In addition, a second object of the present invention is to reduce the incision to one place to facilitate the surgery.

In addition, the third object of the present invention is to reduce the complications that may occur during incontinence surgery due to the above two and to facilitate the surgery.

The present invention provides a urinary incontinence treatment apparatus comprising: a tape implanted into the central urethra of the human pelvic cavity to provide support to the urethra; A pair of fixing parts each connected to both ends of the tape, wherein the fixing parts perform relative movement with respect to the fixing part by a load provided from the outside, a part of which protrudes from the fixing part. At least one locking member is included.

Preferably, the fixing part is formed in a pair of at least one protrusion jaw and at least one protrusion groove is formed on each of the side surfaces corresponding to each other, the at least one protrusion jaw is formed on one side, the other side corresponding to the protrusion jaw An outer housing in which protrusion grooves are formed; At least one locking member coupled to an outer circumference of the protruding groove to form a coupling tool so as to be rotatable, and a plurality of first gears formed at a predetermined angle on an outer circumference of the coupling tool; And a second gear meshed with the first gear at predetermined intervals at both ends thereof, wherein the moving member rotates the first gear by the movement of the second gear.

Preferably, the locking member is formed in a hook shape so that it can be easily fixed to the closed muscle of the pelvic cavity during surgery.

Preferably, the locking member further includes at least one hook shape.

Preferably, the fixing part is formed of a bioabsorbable material or a compound harmless to the human body.

Preferably, the blade insertion piece is formed on one outer side of any one of the pair of outer housings.

Preferably, the rotating member is rotated by a load that applies the moving member in one direction, and includes a pressing member separated from the moving member.

Preferably, at least one connection jaw and a connection groove are respectively formed on a corresponding inner surface of the pair of outer housings so as to fix an end of the tape.

Preferably, a first movement preventing piece is formed on an inner surface of any one of the pair of outer housings, and a second movement preventing piece having a shape corresponding to the first movement preventing piece is formed on one side of the moving member. By the movement of the movable member to the locking member is rotated to the outside of the external load housing and then intermittently fixed.

Preferably, the first movement preventing piece and the second movement preventing piece are formed in a sawtooth shape or a ratchet shape.

As described above, according to the present invention, the urinary incontinence treatment apparatus of the present invention has the following effects.

First, the urinary incontinence treatment apparatus of the present invention is fixed in the opposite direction of the deflection by the first movement preventing piece and the second movement preventing piece even if the deflection phenomenon occurs on the tape supporting the urethra after the urinary incontinence surgery By moving the government, there is an advantage that the support for urethra is not degraded.

Second, the urinary incontinence treatment apparatus of the present invention by fixing the fixed portion connected to both ends of the tape after the urinary incontinence surgery to the pelvic cavities in the human body, respectively, There is no need for an incision, and there is no need for suture surgery separately from the human body to perform the operation conveniently.

Third, the urinary incontinence treatment apparatus of the present invention can be provided by selectively adjusting the supporting force provided to the urethra during the operation of urinary incontinence by using the movable member and the locking member.

Although described above with reference to a preferred embodiment of the present invention, those skilled in the art will be variously modified and changed within the scope of the invention without departing from the spirit and scope of the invention described in the claims below I can understand that you can.

As the invention allows for various changes and numerous embodiments, particular embodiments will be illustrated in the drawings and described in detail in the written description. However, this is not intended to limit the present invention to specific embodiments, it should be understood to include all modifications, equivalents, and substitutes included in the spirit and scope of the present invention. Like reference numerals are used for like elements in describing each drawing.

When a component is referred to as being "connected" or "connected" to another component, it may be directly connected to or connected to that other component, but it may be understood that other components may be present in between. Should be. On the other hand, when a component is said to be "directly connected" or "directly connected" to another component, it should be understood that there is no other component in between.

The terminology used herein is for the purpose of describing particular example embodiments only and is not intended to be limiting of the present invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In this application, the terms "comprise" or "have" are intended to indicate that there is a feature, number, step, operation, component, part, or combination thereof described in the specification, and one or more other features. It is to be understood that the present invention does not exclude the possibility of the presence or the addition of numbers, steps, operations, components, components, or a combination thereof.

Unless defined otherwise, all terms used herein, including technical or scientific terms, may have the same meaning as commonly understood by one of ordinary skill in the art. Terms such as those defined in commonly used dictionaries are to be interpreted as having a meaning consistent with the meaning in the context of the relevant art and are to be interpreted as ideal or overly formal in meaning unless explicitly defined in the present application Do not.

 Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In order to facilitate a thorough understanding of the present invention, the same reference numerals are used for the same means regardless of the number of the drawings.

1 is a perspective view of the urinary incontinence treatment apparatus according to an embodiment of the present invention, Figure 2 is a perspective view of a fixed portion of the urinary incontinence treatment apparatus according to an embodiment of the present invention.

Referring to Figure 1, the urinary incontinence treatment device 100 of the present invention may be configured to include a tape (110: tape), a fixing portion 120, the pressing member 130 and the surgical blade 140.

The tape 110 has a predetermined length and width to be inserted into the lower abdomen of the human body to support the lower part of the urethra. In addition, if the length of the tape 110 is short, it is difficult to control, and if the length is long, it is preferable that the tape 110 be appropriately formed because it can lead to waste of materials.

In addition, when the width of the tape 110 is less than 1.1 cm, it is difficult to support it to raise the urethra, and when the width is more than 1.1 cm, the lower abdominal incision region of the vagina becomes wider, preferably about 1.1 cm wide. It is preferable.

In addition, the tape 110 is made of a material having a certain strength that is harmless to the human body and is not easily broken, but is preferably a mesh-type mesh tape that is resistant to water or moisture and does not adsorb to the surgical suture chamber. Do.

In addition, the fixing part 120 is connected to each of both ends of the tape 110.

The fixing part 120 is connected to both end portions of the tape 110, respectively, and includes an outer housing 121 and 122, a locking member 123, and a moving member 124.

The fixing part 120 passes through an incision (not shown) around the vagina during urinary incontinence surgery and is positioned to support the lower part of the urethra with the tape 110, and then to the obturator muscles of both pelvic cavities around the vagina. The fixing part 120 is fixed to provide support to the urethra.

The outer housings 121 and 122 are formed in a pair, and at least one protruding jaw 121a is formed on each of both side surfaces corresponding to each other, and the at least one protruding jaw 121a is coupled to each other. ) Is formed in each of the outer housings 121 and 122 at positions corresponding to the protruding jaw 121a.

At this time, the inner circumferential diameter of the protruding groove 122a is formed to be the same or corresponding to the outer circumferential diameter of the protruding jaw 121a so that they can be fixed by fitting to each other, or formed by various locking methods. Of course you can.

Here, the pair of outer housings 121 and 122 are spaced by a predetermined interval by the combination of the protrusion groove 122a and the protrusion jaw 121a to form a receiving space.

In addition, the first movement preventing piece 122b is formed on the inner surface of any one of the pair of outer housings 121 and 122, and the first movement preventing piece 122b is preferably the protruding groove 122a. It is preferable to form the formed in the central portion of the outer housing 122 is formed.

In addition, at least one connecting jaw 121e is formed in the outer housing 121 at a position spaced apart from the at least one protruding jaw 121a, and the connecting jaw 121e and the corresponding outer housing 122 are formed. At least one connection groove 122e is formed on one side of the side to be coupled to each other, but the inner circumferential diameter of the connection groove 122e is formed to be equal to or corresponding to the outer circumferential diameter of the connection jaw 121e. It is desirable to.

Here, the formation position of the connection jaw 121e and the connection groove 122e may be selectively changed.

In addition, the at least one connection groove (122e) is formed at a position corresponding to the coupling jaw (121e) to fit, but before coupling the connection jaw (121e) to the connection groove (122e), After the tape 110 is connected, the tape 10 is fixed by coupling the connection groove 122e and the connection jaw 121e.

The locking member 123 is provided with at least one, the coupling hole 123a is formed to be coupled to the outer periphery of the at least one protruding groove (122a) is rotatable. Here, the coupler (123a) is formed to be larger than or corresponding to the outer peripheral diameter of the protrusion groove (122a).

In addition, the locking member 123 is formed with a plurality of first gears (123c) at predetermined intervals on the outer periphery of the coupling hole (123a) is formed to be rotatable at a predetermined angle by a load provided from the outside.

In addition, the locking member 123 is preferably formed in a spike shape or hook shape so as to be firmly fixed to the closed muscle of the human pelvic cavity.

In addition, at least one hook shape formed on the locking member 123 may be formed (see “A” enlarged view of FIG. 3) to be more easily fixed to the closed muscle.

The locking member 123 is protruded by a rotational movement to the outside of the outer housing 121, 122 by an external physical force.

The moving member 124 has a plurality of second gears (124c) are formed at both ends at predetermined intervals, the second gear 124c is meshed with the first gear (123c) of the moving member 124 The locking member 123 is rotated to the outside of the outer housings 121 and 122 by the movement.

In addition, a second movement preventing piece 124b having a shape engaged with the first movement preventing piece 122b is formed at the center of one side of the moving member 124 on which the second gear 124c is formed.

The first movement preventing member 122b and the second movement preventing member 124b rotate the locking member 123 engaged with the second gear 142c after the moving member 124 is moved in one direction. After fixing it plays a role.

Here, the first movement preventing piece 122b and the second movement preventing piece 124b are preferably formed in a sawtooth or ratchet shape so as to fix the moving member 124.

 In addition, after the locking member 123 of the fixing part 120 is fixed to the closed muscles of the human body, the locking member 123 to the first movement preventing piece 122b and the second movement preventing piece 124b. By fixing it, it is possible to provide a more robust support for a long time to the tape (110).

In addition, the second gear 124c is engaged with the second gear 124c and the second gear 124c moves in one direction by a load applied to the rear of the movable member 124. The locking member 123 protrudes to the outside of the outer housings 121 and 122 by rotating the first gear 123c engaged with the 124c.

At this time, the second movement preventing piece 124b meshed with the first movement preventing piece 122b is also moved by a predetermined interval by the movement of the moving member 124.

Here, the first gear 123c and the second gear 124c may be configured in the form of rack and pinion.

In addition, since the fixing part 120 is fixed to the closed muscle of the pelvic cavity, the fixing part 120 may be formed of a bioabsorbable material or a material (compound) that is harmless to the human body.

In addition, the blade insertion piece 122d is formed on one side of the outer side of the fixing part 120 to be coupled to the surgical blade 140 for inducing the fixing part 120 when the human body is inserted.

The pressing member 130 is provided separately, and serves to move the moving member 124 in one direction by pressing the rear of the moving member 124 with a predetermined force.

In addition, the pressing member 130 moves the movable member 124 of the fixing part 120 from the rear side so that the tape 110 provides a proper supporting force to the urethra, the locking member 123 is rotated so that the pelvic cavity When fixed to the closing muscles of, the moving member 124 is separated from the rear.

Here, the pressing member 130 may be formed integrally with the moving member 124, or may be formed to be cut after being formed integrally.

The surgical blade 140 guides the fixing part 120 into the human body and fixes it to the closed muscles, and is separated from the blade insertion piece 122d of the fixing part 120.

Figure 3 is an exemplary view of the operation of the urinary incontinence treatment apparatus according to an embodiment of the present invention.

Referring to FIG. 3, the patient first needs a hyperflexed buttock posterior lithography position in the lower abdomen of the human body, ie, around the vagina, so that the urinary incontinence treatment apparatus 100 of the present invention can be performed. (dorsal lithotomy position) and the bladder is emptied.

Thereafter, an incision 30 is formed at 2 cm along the center of the anterior vaginal wall of the patient, and the obturator foramen (40a) position of the human pelvic cavity (Pelves) is positioned through the incision 30. The fixing part 120 of one side is inserted into the closing hole 40a to be drawn out, and the drawn part 120 is fixed to the closing muscle 10a disposed around the pelvic cavity. Not shown) using the predetermined force to move the moving member 124 so that the locking member 123 protrudes out of the fixing portion 120 to fix the locking member 123 to the closed muscle (10a) do.

In addition, the withdrawal is passed through the fixing part 120 of the other side through the closed hole 40b located on the other side, and at this time, the tape 110 supports the lower end of the urethra and is positioned to have a predetermined tension. As in the method, the fixing part 120 may be fixed to the closed muscle 10b to complete the surgery.

Therefore, a large number of incisions are not required, and the operation time is shortened, and the tape does not need to be sewn on the human body, so that the operation can be easily performed.

1 is a front view of the urinary incontinence treatment apparatus according to an embodiment of the present invention;

Figure 2 is an exploded perspective view of the fixing portion of the urinary incontinence treatment apparatus according to an embodiment of the present invention.

Figure 3 is an illustration of the operation of the urinary incontinence treatment apparatus according to an embodiment of the present invention.

* Description of the symbols for the main parts of the drawings *

10a, 10b: obstructive muscle 30: incision

40a, 40b: closed hole

100: urinary incontinence treatment device 110: tape

120: fixing part 121, 122: external housing

121a: protruding jaw 121e: connecting jaw

122a: protrusion groove 122e: connection groove

122b: first movement preventing piece 122d: blade insertion piece

123: locking member 123a: coupling

123c: first gear 124: moving member

124c: second gear 124b: second movement prevention piece

130: pressure member 140: guide blade for the procedure

Claims (10)

A tape implanted into the urethral neck of the human pelvic cavity to provide support to the urethra; And A pair of fixing parts connected to both ends of the tape, respectively; The fixing part, An outer housing having a pair of at least one protruding jaw formed on one of both sides corresponding to each other, and at least one protruding groove formed on the other of the protruding jaws; A coupler is coupled to the outer periphery of the protruding groove so that the coupler is rotatable, and a plurality of first gears are formed at a predetermined angle on the outer periphery where the coupler is formed, and at least one rotated to protrude out of the outer housing. Locking member; and The second gear meshed with the first gear is formed at both ends at predetermined intervals, and includes a moving member for rotating the first gear by the movement of the second gear. delete The method of claim 1, wherein the locking member Urinary incontinence treatment apparatus, characterized in that formed in the shape of a hook to be easily fixed to the closed muscles of the pelvic cavity during surgery. The method of claim 3, At least one hook shape is formed on the engaging member further comprises urinary incontinence treatment apparatus. The method of claim 1, The incontinence treatment device, characterized in that the fixing portion is formed of a bioabsorbable material. The method of claim 1, Urinary incontinence treatment apparatus, characterized in that the blade insert is formed on one of the outer one side of the outer housing of the pair. The method of claim 1, And a urging member which is separated from the moving member after the locking member is rotated by a load that applies the moving member in one direction. The method of claim 1, And at least one connection jaw and a connection groove are formed on corresponding inner surfaces of the pair of outer housings, respectively, so as to fix an end portion of the tape. The method of claim 1, The first movement preventing piece is formed on the inner surface of any one of the pair of outer housings, and the second movement preventing piece having a shape corresponding to the first movement preventing piece is formed on one side of the moving member. The urinary incontinence treatment apparatus, characterized in that for interlocking to be fixed after the locking member is rotated to the outside of the outer housing by the movement of the moving member. 10. The method of claim 9, The first movement preventing piece and the second movement preventing piece is incontinence treatment apparatus, characterized in that formed in the sawtooth shape or ratchet shape.

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