RU169016U1 - Artificial Bladder Sphincter - Google Patents

Abstract

The invention relates to surgical devices and can be used to eliminate severe urinary incontinence in patients. An artificial bladder sphincter having a body with a magnetic urethral compression system, characterized in that the device consists of a hollow body and reservoir made of biologically inert elastic material, connected to each other by a hollow tube; the housing has side lobes with holes; in front of the body has a foot with a permanent magnet, which is located in a recess on the outer surface of the foot; the back of the housing has an inward recess in which a plate of ferromagnetic material is located; the permanent magnet and plate are biologically inert; the external dimensions of the recesses on the foot and the back of the body are smaller than their internal dimensions; from the inside, the front and rear parts of the body have saddle-shaped recesses to which the urethra is adjacent; the reservoir contains sterile saline.

Description

The utility model relates to surgical devices and can be used to eliminate severe urinary incontinence in patients.

Known artificial sphincter of the bladder, consisting of two plates of biologically inert material into which permanent magnets are implanted. Two plates are connected by elastic locks to prevent urethral migration. Before filling the bladder, the artificial sphincter reliably squeezes the urethra by the force of attraction of magnets, preventing spontaneous leakage of urine. If urination is necessary, the muscles of the bladder are tensed and the pressure of the urine magnifies the artificial sphincter magnets to the side, providing an act of urination. After a drop in urine pressure, the magnets come together again and provide compression of the urethra [1]. The disadvantages of the device are: the limited functionality of the sphincter, since it does not allow external control of the act of urination, as well as insufficient reliability due to the fragility of the elastic locks.

An artificial bladder sphincter containing an urethral elastic clamp connected to a magnetic element and made in the form of a bracket, on the cantilever parts of which permanent magnets connected by a flexible magnetic circuit on which a control winding is installed, was chosen as a prototype. The artificial sphincter is controlled using an additional external device, which, through induction coupling, transfers the sphincter to one of the stable states - open or closed. The device is fixed to the periosteum of the pubic bone [2].

The disadvantages of the device are: the limited functionality of the sphincter, since it does not allow the act of urination without an external device, as well as insufficient reliability due to the possibility of device failure due to the discharge of batteries.

The technical result of using the inventive device is to create an artificial sphincter of the bladder, preventing urinary incontinence and providing, if necessary, its free passage.

The technical result is achieved in that the device consists of a hollow body and a tank made of a biologically inert elastic material, connected to each other by a hollow tube; the housing has side lobes with holes; in front of the body has a foot with a permanent magnet, which is located in a recess on the outer surface of the foot; the back of the housing has an inward recess in which a plate of ferromagnetic material is located; the permanent magnet and plate are biologically inert; the external dimensions of the recesses on the foot and the back of the body are smaller than their internal dimensions; from the inside, the front and rear parts of the body have saddle-shaped recesses to which the urethra is adjacent; the reservoir contains sterile saline.

Holes in the side lobes of the body are necessary for fixing the artificial sphincter to the surrounding tissues with a needle with suture material. The outer dimensions of the recesses on the foot and the back of the case are smaller than their internal dimensions - including due to the elastic material of the case, this ensures reliable fixation in the recesses of the permanent magnet and plate. The saddle-shaped recesses of the front and rear of the body, which are attracted to each other due to the magnetic system, form a urethral clamp. When the patient presses the reservoir, the physiological solution flows through the tube into the hollow body, while the permanent magnet and the plate are removed from each other, which ensures free passage of urine. When the patient stops pressure on the reservoir, physiological saline from the body through the tube returns to it, the permanent magnet and the plate come together again, providing the formation of the urethral clamp.

The artificial sphincter of the bladder consists of a hollow body and reservoir made of a biologically inert elastic material, connected to each other by a hollow tube; the housing has side lobes with holes; in front of the body has a foot with a permanent magnet, which is located in a recess on the outer surface of the foot; the back of the housing has an inward recess in which a plate of ferromagnetic material is located; the permanent magnet and plate are biologically inert; the external dimensions of the recesses on the foot and the back of the body are smaller than their internal dimensions; from the inside, the front and rear parts of the body have saddle-shaped recesses to which the urethra is adjacent; the reservoir contains sterile saline.

The utility model is illustrated by graphic material. In FIG. 1. shows a diagram of an artificial bladder sphincter. In FIG. 2a shows the sphincter in the closed state during retention of urine, in FIG. 2b - in the open state. The artificial bladder sphincter has a body 1 with side lobes 2 having openings 3. The front of the body 1 has a foot 4 with a permanent magnet 5, which is located in a recess on the outer surface of the foot 4. The back of the body 1 has an outside recess in which the plate is located 6 made of ferromagnetic material. On the inner side, the front and rear parts of the housing 1 have saddle-shaped recesses to which the urethra 7 is adjacent. The housing 1 is connected via a tube 8 to a reservoir 9 in which physiological saline is located. In fig. 2b, reservoir 9 is depicted in a compressed state; physiological saline is in the hollow body 1, due to which the urethral clamp loosens, the urethra 7 expands and free passage of urine occurs.

Artificial sphincter is used as follows. The sphincter is fixed intraoperatively to the surrounding soft tissues by passing a surgical needle through the holes in the side lobes of the body. Place the urethra between the saddle-shaped recesses of the front and rear of its body, releasing the foot. The foot is gently lowered, allowing the sphincter to squeeze the urethra due to magnetic attraction between the permanent magnet and the plate of ferromagnetic material. The tube is placed along the urethra, and the reservoir with saline is in the scrotum. If urination is necessary, the patient compresses the reservoir in the scrotum, ensuring the delivery of physiological solution through the tube into the hollow body, due to which the permanent magnet and the artificial sphincter plate are pulled apart, providing the necessary urethral clearance for free passage of urine. After the pressure on the reservoir is over, the physiological saline from the body returns through the tube into it, the permanent magnet and the plate come together again, providing the formation of a urethral clamp.

Thus, the design of the artificial sphincter is simple and reliable. Implantation of such a sphincter is quick, easy and less traumatic.

The use of the proposed device is illustrated by a clinical example. Patient K., 68 years old. He entered the Department of Urology Clinics SamSMU with a diagnosis of Stress urinary incontinence 3 tbsp. Condition after transurethral resection of the prostate gland. Surgery: implantation of the proposed artificial sphincter of the bladder. After isolating the bulbous section of the urethra and determining its circumference, the sphincter was established and fixed. They trained the patient to use the sphincter. The postoperative period was uneventful. Volume with a single urination of 170 ml. The patient was discharged on the seventh day after surgery. A good long-term functional effect has been achieved.

Implantation of an artificial bladder sphincter is an effective method for the treatment of urinary incontinence and allows you to replace the natural sphincter of the bladder, providing a high quality of life and social adaptation of patients. The artificial sphincter of the bladder can be widely used in surgical practice, in particular in the work of urological departments.

Used Books

1. Utility model of the Russian Federation No. 140189. Artificial sphincter of the bladder / Nizamova R.S., Gubanov E.S., Zhuravlev A.N., Ibatullin I.D., Boryaev E.A. Publ. 04/27/2014.

2. AC No. 558672. Artificial sphincter / Kuznetsov M.V., Livshits A.V., Stepanov L.V. Publ. 05/25/1977, bull. No. 19.

Claims (1)

An artificial bladder sphincter having a body with a magnetic system for compressing the urethra, characterized in that the device consists of a hollow body made of a biologically inert elastic material and a reservoir connected to each other by a hollow tube; the housing has side lobes with holes; in front of the body has a foot with a permanent magnet, which is located in a recess on the outer surface of the foot; the back of the housing has an inward recess in which a plate of ferromagnetic material is located; the permanent magnet and plate are biologically inert; the external dimensions of the recesses on the foot and the back of the body are smaller than their internal dimensions; from the inside, the front and rear parts of the body have saddle-shaped recesses to which the urethra is adjacent; the reservoir contains sterile saline; wherein the permanent magnet and the plate are configured to be removed from each other when physiological saline enters the hollow body.

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