US1750654A - Urethral clip - Google Patents

Urethral clip Download PDF

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US1750654A
US1750654A US355703A US35570329A US1750654A US 1750654 A US1750654 A US 1750654A US 355703 A US355703 A US 355703A US 35570329 A US35570329 A US 35570329A US 1750654 A US1750654 A US 1750654A
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jaw
clip
cross
loop
springs
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US355703A
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Reinhold H Wappler
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/005Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra with pressure applied to urethra by an element placed in the vagina
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T24/00Buckles, buttons, clasps, etc.
    • Y10T24/44Clasp, clip, support-clamp, or required component thereof
    • Y10T24/44641Clasp, clip, support-clamp, or required component thereof having gripping member formed from, biased by, or mounted on resilient member

Definitions

  • My present invention relates generally to surgical devices, and has particular reference to a urethral clip.
  • anesthetics In the application of anesthetics to the urethra, it is customary to employ a clip for the purpose of retaining the meatus closed so that the anesthetic may be retained in position to enable it to work.
  • a clip or device of this character must have sufficient tenacity to fulfill this function, but at the same time the force of engagement must not be too great, and must be gentle enough to avoid any interruption of blood circulation.
  • a particular object is to provide a clip which is constructed in a novel manner so that the tenacity thereof is uniformly gentle but decidedly firm.
  • a particular feature of my invention lies in the provision of a device which is perfectly symmetrical and whose weight distribution is therefore uniform, the manipulation being thereby greatly facilitated and the device being corespondingly efficient in use.
  • my invention resides in the provision of nothing more than a loop element and a cross-piece element, these elements be ing operatively associated by means of a spring of the foregoing character so arranged and mounted that it fulfills its function in the most eflicient manner without in the least impairing the symmetrical and compact nature of the device.
  • Figure 1 is a perspective view of a clip em- 30 bodying the features of my invention, showing the same in the grasp of the right hand of an operator, with the two jaws thereof opened;
  • Figure 2 is a plan view of the device of Figure 1, this View being approximately 1% times natural size;
  • Figure 3 is a cross-sectional view taken substantially along the line 33 of Figure 2;
  • Figure 4 is a view similar to Figure 2 illustrating a modified type of clip.
  • Figure 5 is a cross-sectional view taken substantially along the line 55 of Figure 4:.
  • FIGS 2 and 3 I have illustrated a loop element 10 which is substantially circu-v lar, this element being preferably constructed of light metallic tubing approximately inch in diameter, the entire loop being 1% inches in diameter.
  • a portion of this element is shaped and constructed to form a jaw and I have illustratively shown a flattening throughout an arc of approximately 90 to provide the jaw 11. It is to be noted that the plane of the flattened portion 11 is in the plane of the loop as a whole.
  • a complementary jaw 12 which may consist of a similar flattened strip of suitable metal conformably shaped with respect to the jaw 11 so that normally the two jaws overlie one another as shown in Figures 2' and 3.
  • the direction in which Figure 1 is taken makes it appear as though the jaw 12 were concave, but as a matter of fact, the jaw 12 lies in a plane parallel to that of the jaw 11 when the two are superposed as shown in Figure 3.
  • Carrying the jaw 12 is a cross-piece element 13 which extends diametrically across the loop element 10 to a point diametrically opposite the jaws 11 and 12.
  • the element 13 in Figures 2 and 3 I have shown the element 13 as a substantially flat metallic piece suitably attached, as by soldering or the like, to the midortion of the jaw 12.
  • the element 13 does not lie in a plane strictly parallel to the plane of the looped element 10 but transverses the plane of the latter so that the lower or rear end of the element 13 lies substantially in the plane of the flattened portion Or jaw 11.
  • each of the springs 14 and 15 has an end arranged at the point opposite the jaws. These ends are designated by the reference numerals 16 and 17 respectively, and they are suitably fastened or attached to the rear end of the cross-piece element 13. I have illustratively shown the rear end of the element 13 tubular as at 18, and I have shown the manner in which the ends 16 and 17 may be jammed into position within this tubular portion 18.
  • the springs 14 and 15 extend in opposite directions, the opposite end 19 of the spring 14 being suitably attached at a relatively remote point to the loop element 10, and the opposite end 20 of the spring 15 being suitably attached at a symmetrical point on the loop element 10.
  • the attachments of the ends 19 and 20 may be effected, if desired, by passing them through suitable openings into the interior of the loop element 10.
  • each spring 14 and 15 are coiled in opposite directions, or, stated otherwise, they are symmetrically coiled with respect to the medial longitudinal axis of the cross-piece element 13. It is also to be observed that each spring is coiled throughout a substantial arcuate extent of the loop element lO, the illustrated embodiment showing each spring coiled throughout an arc of approximately 90". It is the fine nature of the springs 14 and 15 and the substantial length thereof which imparts to my device the highly desirable gentle but unquestionably firm grasp.
  • FIGs 4 and 5 I have shown a slightly modified type wherein the loop element 21 conforms to a figure-U with the upper ends thereof joined. It is this connecting upper portion 22 which constitutes one of the jaws, and the portion 22 is preferably flattened as shown in Figure 5.
  • a complementary jaw 23 which conforms to the jaw 22 and which may comprise a substantially flat and straight strip of suitable metal or the like.
  • a cross-piece element 24 is medially attached to the jaw 23 and extends diametrically across the loop element much in the same manner as before.
  • the cross-piece element 24 constituted of a single tube which is entirely unflattened. A construction of this character may in certain cases be desirable, although it might be simpler to handle if at least a midportion thereof were flattened or provided with an attached fiat plate or the like for receiving the thumb of the user.
  • the springs 25 and 26 are similar to the springs 14 and 15 and are similarly wound symmetrically with respect to the longitudinal axis of the cross-piece element 24. ⁇ Vith the U-shaped contour it is possible to give these springs even greater length, and I have illustratively shown each spring extending all the way from the point of attachment to the cross-piece element 24 to the extreme end of the aw 22.
  • the tenacity of the device is fixed and unalterable by the operator.
  • the tenacity may be controlled and adjusted to a nicety by merely coiling the springs by one or more turns, more or less, around the loop element 10.
  • the cross-piece element 13 would not be fastened to the ends 16 and 17 until these ends had been looped once more around the element 10.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary aw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means including a spring coiled around said loop element.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs coiled in opposite directions around said loop element.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs fastened to said cross-piece element at said point and extending in opposite directions therefrom.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs coiled around said loop element, each spring having an end attached tosaid cross-piece element at said point, and said springs extending in opposite directions from said point.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and a spring interposed between said elements for normally holding said jaws together, said spring being coiled around said loop element throughout a substantial arcuate length of the latter.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a j aw, a cross-piece element provided with a complementary jaw, and a pair of springs interposed between said elements for normally holding the jaws together, said springs being coiled in opposite directions around said loop element throughout substantial arcuate lengths of the latter.
  • a surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw and extending diametrically across said loop element whereby the rear end of said cross-piece element is diametrically opposite said jaws; and a pair of springs coiled around said loop element and symmetrically arranged with respect to said crosspiece element, each spring being fastened at one end to said rear end and at its opposite end to said loop element.

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  • Health & Medical Sciences (AREA)
  • Urology & Nephrology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

March 18, 1930. R. H. WAPFLER 1,750,654
URETHRAL CLIP Filed April 17, 1929 Patented Mar. 18, 1930 UNITED STATES BEINHOLD H. WAIPLER, OF YONKERS, NEW YORK URETHRAL CLIP Application filed April 17,
My present invention relates generally to surgical devices, and has particular reference to a urethral clip.
In the application of anesthetics to the urethra, it is customary to employ a clip for the purpose of retaining the meatus closed so that the anesthetic may be retained in position to enable it to work. A clip or device of this character must have sufficient tenacity to fulfill this function, but at the same time the force of engagement must not be too great, and must be gentle enough to avoid any interruption of blood circulation.
With the employment of clips whose degree of tenacity is variable and under the control of the surgeon or operator, difliculties have frequently been encountered because of the fact that in certain cases the same is ap plid with too strong a grip and in other cases 0 with too unfirm a grip, and because of the fact that different operators have different strengths and do not uniformly use the same judgment. It is therefore desirable that clips of this character be so constructed that the tenacity thereof be independent of the particular user or his particular judgment.
It is a general object of my present invention to provide a clip of this character, and more particularly, a clip of the character wherein resilient means predetermines the strength of engagement. A particular object is to provide a clip which is constructed in a novel manner so that the tenacity thereof is uniformly gentle but decidedly firm.
Other objects lie in providing a clip having the highly desirable attributes of extreme lightness, compactness, and simplicity. It is a particular object to provide a device which is easily manipulable and whose employment is accordingly a matter of ease and simplicity and devoid of any of the clumsy annoyances heretofore encountered.
A particular feature of my invention lies in the provision of a device which is perfectly symmetrical and whose weight distribution is therefore uniform, the manipulation being thereby greatly facilitated and the device being corespondingly efficient in use.
My successful provision of a clip having the requisite smallness of size, lightness in 1929. Serial No. 355,703.
weight, and firmness of engagement is predicated upon the employment of a novel type of spring arrangement, my invention having recourse to the desirable characteristics of a very fine and long strip of spring metal such as phosphor-bronze coiled into a helix. A particular feature of my invention lies in the novel employment of this type of spring and in the manner of assembling the several parts without resorting in any way to the employment of hinges or other elements which would complicate the construction, render the manufacture more expensive, and increase the weight and complexity of the device.
Briefly, my invention resides in the provision of nothing more than a loop element and a cross-piece element, these elements be ing operatively associated by means of a spring of the foregoing character so arranged and mounted that it fulfills its function in the most eflicient manner without in the least impairing the symmetrical and compact nature of the device.
For the attainment of the foregoing objects W and such other objects as may hereinafter appear or be pointed out, I have constructed a device embodying the features of my invention and illustrated in the accompanying drawings wherein Figure 1 is a perspective view of a clip em- 30 bodying the features of my invention, showing the same in the grasp of the right hand of an operator, with the two jaws thereof opened;
Figure 2 is a plan view of the device of Figure 1, this View being approximately 1% times natural size;
Figure 3 is a cross-sectional view taken substantially along the line 33 of Figure 2;
Figure 4 is a view similar to Figure 2 illustrating a modified type of clip; and
Figure 5 is a cross-sectional view taken substantially along the line 55 of Figure 4:.
In Figures 2 and 3 I have illustrated a loop element 10 which is substantially circu-v lar, this element being preferably constructed of light metallic tubing approximately inch in diameter, the entire loop being 1% inches in diameter. A portion of this element is shaped and constructed to form a jaw and I have illustratively shown a flattening throughout an arc of approximately 90 to provide the jaw 11. It is to be noted that the plane of the flattened portion 11 is in the plane of the loop as a whole.
Cooperating with the jaw 11 is a complementary jaw 12 which may consist of a similar flattened strip of suitable metal conformably shaped with respect to the jaw 11 so that normally the two jaws overlie one another as shown in Figures 2' and 3. The direction in which Figure 1 is taken makes it appear as though the jaw 12 were concave, but as a matter of fact, the jaw 12 lies in a plane parallel to that of the jaw 11 when the two are superposed as shown in Figure 3.
Carrying the jaw 12 is a cross-piece element 13 which extends diametrically across the loop element 10 to a point diametrically opposite the jaws 11 and 12. In Figures 2 and 3 I have shown the element 13 as a substantially flat metallic piece suitably attached, as by soldering or the like, to the midortion of the jaw 12. Upon reference to igure 3 it will be seen that the element 13 does not lie in a plane strictly parallel to the plane of the looped element 10 but transverses the plane of the latter so that the lower or rear end of the element 13 lies substantially in the plane of the flattened portion Or jaw 11.
The elements 13 and 10 are pivotally associated at the point diametrically opposite the jaws 11 and 12, but no hinges or pivots are employed, the desired articulation being effected by the operative interposition of a pair of springs 14 and 15. Each of the latter is preferably constructed of very fine yet high-grade spring metal such as phosphorbronze, and each of these springs conforms to the loop element 10 by being coiled about the latter. Upon reference to Figure 2 it is to be noted that each of the springs 14 and 15 has an end arranged at the point opposite the jaws. These ends are designated by the reference numerals 16 and 17 respectively, and they are suitably fastened or attached to the rear end of the cross-piece element 13. I have illustratively shown the rear end of the element 13 tubular as at 18, and I have shown the manner in which the ends 16 and 17 may be jammed into position within this tubular portion 18.
Extending from this point of attachment, the springs 14 and 15 extend in opposite directions, the opposite end 19 of the spring 14 being suitably attached at a relatively remote point to the loop element 10, and the opposite end 20 of the spring 15 being suitably attached at a symmetrical point on the loop element 10. The attachments of the ends 19 and 20 may be effected, if desired, by passing them through suitable openings into the interior of the loop element 10.
It is to be noted that the springs 14 and 15 are coiled in opposite directions, or, stated otherwise, they are symmetrically coiled with respect to the medial longitudinal axis of the cross-piece element 13. It is also to be observed that each spring is coiled throughout a substantial arcuate extent of the loop element lO, the illustrated embodiment showing each spring coiled throughout an arc of approximately 90". It is the fine nature of the springs 14 and 15 and the substantial length thereof which imparts to my device the highly desirable gentle but unquestionably firm grasp.
In Figures 4 and 5 I have shown a slightly modified type wherein the loop element 21 conforms to a figure-U with the upper ends thereof joined. It is this connecting upper portion 22 which constitutes one of the jaws, and the portion 22 is preferably flattened as shown in Figure 5. In this embodiment, there is a complementary jaw 23 which conforms to the jaw 22 and which may comprise a substantially flat and straight strip of suitable metal or the like. Here too, a cross-piece element 24 is medially attached to the jaw 23 and extends diametrically across the loop element much in the same manner as before. In the form of Figures 4 and 5 I have shown the cross-piece element 24 constituted of a single tube which is entirely unflattened. A construction of this character may in certain cases be desirable, although it might be simpler to handle if at least a midportion thereof were flattened or provided with an attached fiat plate or the like for receiving the thumb of the user.
The springs 25 and 26 are similar to the springs 14 and 15 and are similarly wound symmetrically with respect to the longitudinal axis of the cross-piece element 24. \Vith the U-shaped contour it is possible to give these springs even greater length, and I have illustratively shown each spring extending all the way from the point of attachment to the cross-piece element 24 to the extreme end of the aw 22.
The employment of the device will be obvious from the description given, and Jarticularly upon reference to Figure 1. t is grasped in the manner shown, the index and adjacent finger being positioned on opposite sides of the medial axis of the device and the thumb being placed against the cross-piece element as shown. By merely pressing the thumb, the jaws may be opened as shown in Figure 1. This manner of grasping and manipulating the device is extremely eflicient and is the natural way in which any article might be picked up by the surgeon. No particular manipulation of the parts is required and hardly any instructions need accompany the device in order to illustrate its manner of use.
It is to be noted that the tenacity of the device is fixed and unalterable by the operator.
At the same time, during the manufacture thereof, the tenacity may be controlled and adjusted to a nicety by merely coiling the springs by one or more turns, more or less, around the loop element 10. For example, if the clip of Figures 2 and 3 were to be strengthened by a very slight amount, the cross-piece element 13 would not be fastened to the ends 16 and 17 until these ends had been looped once more around the element 10.
I wish to distinguish my present construction particularly from that type of device wherein relatively heavy Wire is employed, the same being formed into one or two loops to provide resilience much the same as this resilience is provided in an ordinary safety pin. Devices of this character are heavy and unwieldy; they are of necessity unsymmetrical; and they are either too strong or too unfirm of grip. On the other hand, my present device is especially light, accurately symmetrical, easily manipulable, and highly efficient in firmly, but not too firmly, effecting an engagement.
It will be obvious that changes in the details herein described and illustrated for the purpose of explaining the nature of my invention may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is therefore intended that these details be interpreted as illustrative and not in a limiting sense.
Having thus described my invention and illustrated its use, what I claim as new and desire to secure by Letters Patent is- 1. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary aw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws.
2. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means including a spring coiled around said loop element.
3. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs coiled in opposite directions around said loop element.
4. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs fastened to said cross-piece element at said point and extending in opposite directions therefrom.
5. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and resilient means conforming to said loop for pivotally associating said elements at a point diametrically opposite to said jaws; said means comprising a pair of springs coiled around said loop element, each spring having an end attached tosaid cross-piece element at said point, and said springs extending in opposite directions from said point.
6. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw, and a spring interposed between said elements for normally holding said jaws together, said spring being coiled around said loop element throughout a substantial arcuate length of the latter.
7. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a j aw, a cross-piece element provided with a complementary jaw, and a pair of springs interposed between said elements for normally holding the jaws together, said springs being coiled in opposite directions around said loop element throughout substantial arcuate lengths of the latter.
8. A surgical clip of the character described comprising a loop element having a portion thereof constructed to form a jaw, a cross-piece element provided with a complementary jaw and extending diametrically across said loop element whereby the rear end of said cross-piece element is diametrically opposite said jaws; and a pair of springs coiled around said loop element and symmetrically arranged with respect to said crosspiece element, each spring being fastened at one end to said rear end and at its opposite end to said loop element.
In witness whereof I have signed and sealed this specification this 16th day of April 1929.
REINHOLD H. WAPPLER.
US355703A 1929-04-17 1929-04-17 Urethral clip Expired - Lifetime US1750654A (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4458682A (en) * 1982-08-02 1984-07-10 Ethicon, Inc. Non-metallic, bio-compatible hemostatic clips (ring lock clips)
US5184629A (en) * 1989-03-20 1993-02-09 Dacomed Corporation Male urinary anti-incontinence device and method
US6039750A (en) * 1996-12-03 2000-03-21 Mentor Corporation Urethral occlusion device for maintaining urinary bladder retention and method of use

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4458682A (en) * 1982-08-02 1984-07-10 Ethicon, Inc. Non-metallic, bio-compatible hemostatic clips (ring lock clips)
US5184629A (en) * 1989-03-20 1993-02-09 Dacomed Corporation Male urinary anti-incontinence device and method
US6039750A (en) * 1996-12-03 2000-03-21 Mentor Corporation Urethral occlusion device for maintaining urinary bladder retention and method of use

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