WO2019069565A1

WO2019069565A1 - Urethral indwelling device

Info

Publication number: WO2019069565A1
Application number: PCT/JP2018/030521
Authority: WO
Inventors: 岡田司郎
Original assignee: 株式会社岡田快適生活研究所
Priority date: 2017-10-03
Filing date: 2018-08-17
Publication date: 2019-04-11
Also published as: JP2019063475A

Abstract

[Problem] To provide a urethral indwelling device that has a simple structure and facilitates a user to personally place the device in and out of the urethra. [Solution] This urethral indwelling device 1 is provided with a urethral stent 10, an auxiliary tip 30, and a connection cord 40 for connecting the urethral stent 10 and the auxiliary tip 30, wherein: the urethral stent 10 is at least provided with a prostate part 15, a sphincter part 21, and a bulbar urethra part 25 which are integrally formed in this order from the leading end side; the prostate part 15 is provided with prostate projection sections 16, 17 which are projections formed at the boundary with the sphincter part 21 and which form a gap between the prostate part 15 and the inner wall of the urethra when the device is indwelled; and the bulbar urethra part 25 is provided with a bulbar urethra projection section 26 that is formed at the boundary with the sphincter part 21.

Description

Urethral indwelling device

The present invention relates to a urethral indwelling device to be indwelled in the urethra.

When the urethral is closed or narrowed due to enlargement of the prostate or the like, and urination disorder occurs, treatment is performed in which a urethral stent for expanding the urethra is placed in the urethra.

Such urethral stents are disclosed, for example, in the following Patent Documents 1 to 3.

JP 2003-52835 A Japanese Patent Application Publication No. 2008-543499 Patent No. 4025648

However, the urethral stents disclosed in Patent Documents 1 to 3 are complicated in structure, and it is premised that a medical worker performs indwelling treatment in the urethra. It is difficult to do.

The present invention has been made in view of such problems, and has a simple structure, which allows a user to easily indwell it in the urethra or take it out of the urethra. An object of the present invention is to provide a urethral indwelling device.

A urethral stent according to the present invention for solving the above problems is a thin rod-shaped urethral stent which is indwelled in the urethra and spreads the prostate urethra, and includes a prostatic part and a sphincter part which are sequentially formed integrally from the tip side. The prostatic part is a protrusion formed at the boundary with the sphincter muscle, and a gap is formed between the inner wall of the urethra and the prostatic part at the time of indwelling The prostatic projection may be provided, and the bulbous urethral part may be provided with a bulbous urethral projection formed at a boundary with the sphincter.

Further, the urethral indwelling device according to the present invention includes the above-mentioned urethral stent, an auxiliary tip which is indwelled in the urethra at the outlet side of the urethral stent, and prevents the urethral stent from coming out of the urethra, and the urethral stent And a connecting cord connecting the auxiliary tip and the auxiliary tip.

According to the urethral indwelling device according to the present invention, the structure is simple, and the user can easily indwell it in the urethra or take it out of the urethra.

FIG. 1 is a plan view of the urethra indwelling device according to the present embodiment. FIG. 2 is a front view of the urethra indwelling device according to the present embodiment. FIG. 3 is a view showing the indwelling state of the urethra indwelling device according to the present embodiment. FIG. 4 is a plan view of an auxiliary chip according to a modification 1 of the present embodiment. FIG. 5 is a plan view of a urethral stent according to a second modification of the present embodiment. FIG. 6 is a view showing the indwelling state of the urethra indwelling device according to the third modification of the present embodiment.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a plan view of the urethra indwelling device according to the present embodiment. FIG. 2 is a front view of the urethra indwelling device according to the present embodiment. FIG. 3 is a view showing the indwelling state of the urethra indwelling device according to the present embodiment.

The urethral indwelling device 1 includes a urethral stent 10, an auxiliary tip 30, and a connecting cord 40 for connecting the urethral stent 10 and the auxiliary tip 30. The urethral stent 10 is mainly located in the prostatic urethra when deployed in the urethra, and functions to spread the prostatic urethra to secure a urine passage.

The urethral stent 10 is a rod-like member that is formed in order from the distal end side and includes a bladder 11, a prostate 15, a sphincter 21 and a bulb urethral 25 and is integrally formed of epoxy resin. In the present specification, when the urethral stent 10 is indwelled in the urethra, the side to be previously inserted in the urethra is referred to as the tip side. The portions of the sphincter 21 and the prostate 15 extend substantially in a straight line, but the bladder 11 and the bulbous urethral 25 are substantially on the same side of the sphincter 21 and the prostate 15 on the same side. It is gently bent at about 45 °.

The bladder portion 11 is in the shape of a thin rod having a length of about 10 mm and a diameter of 2 to 4 mm, and the sphincter muscle portion 21 is also in the shape of a thin rod having a length of about 10 mm and a diameter of 2 to 4 mm. The bulb urethral portion 25 is about 10 mm in length, and includes a bulb urethral flat protrusion 26. The bulb portion urethra flat protrusion portion 26 is a portion that protrudes flatly from the central portion and has a substantially disc shape. The maximum diameter of the bulbous urethral flat projection 26 is 6 to 8 mm, and the thickness is 2 to 4 mm.

The prostate 15 includes a first prostatic protuberance 16, a second prostatic protuberance 17, and a thin rod 18. The first prostatic flat projection 16 is located at the root of the thin rod 18 which is a boundary with the sphincter 21, and the second prostatic flat projection 17 is the tip of the thin rod 18 and the first prostatic flat. Located between 16 and

The prostate

flat protuberances

16 and 17 have substantially the same shape as the bulb urethra flat protuberance 26 and have a substantially disc shape that protrudes flat from the thin rod 18 and has a maximum diameter of 6 to 8 mm and a thickness of 2 to 4 mm. is there. The prostate part 15 is about 30 mm in length, and the diameter of the thin rod part 18 is 2 to 4 mm. The first prostatic protuberance 16 and the second prostatic protuberance 17 are separated by 3 mm.

In the present embodiment, the first prostate flat projection 16, the second prostate flat projection 17, and the bulbous urethral flat projection 26 are located on the same plane, and the bladder 11 is also bent on the same plane. There is. As described above, if the

flat projections

16, 17, 26 and the bending bladder portion 11 are formed on the same plane, the shape of the urethral stent 10 can be simplified and the manufacturing cost can be reduced.

When the urethral stent 10 having such a configuration is placed in the human urethra, the bladder 11 is located in the bladder, the prostate 15 is located in the prostate urethra, and the sphincter 21 is located in the external urethral sphincter The bulb urethral portion 25 is indwelled so as to be located in the bulb urethra.

The auxiliary tip 30 is indwelled in the urethra on the outlet side of the urethral stent 10, and helps the urethral stent 10 not to come out of the urethra during urination and the like, and as an aid for taking the urethral stent 10 out of the urethra. Is also used. Similar to the urethral stent 10, the auxiliary tip 30 is integrally formed of epoxy resin and has a flat elongated plate shape with a thickness of 2 to 4 mm, a width of 6 to 8 mm, and a length of about 25 mm.

The connecting cord 40 is a nylon cord connecting the urethral stent 10 and the auxiliary tip 30. Both ends of the connecting cord 40 are integrally fixed while extending substantially the entire length of the inside of the urethral stent 10 and the auxiliary tip 30. Such a connection structure is realized by resin-molding the urethral stent 10 and the auxiliary tip 30 integrally in a state in which the connection cord 40 is extended inside.

By adopting such a connecting structure, the connecting cord 40 is firmly fixed to the urethral stent 10 and the auxiliary tip 30 and does not come off. Therefore, the connecting cord 40 is removed from the urethral stent 10 inserted in the back of the urethra described later. Work can be performed easily and reliably.

Moreover, even if the urethral stent 10 or the auxiliary tip 30 is broken in the urethra due to any factor, there is a high possibility that the broken pieces are connected by the connecting cord 40, and the work of taking out the pieces is safe and easy It can be carried out.

As mentioned above, although the structure of the urethra indwelling tool 1 was demonstrated, the usage aspect of the urethra indwelling tool 1 is demonstrated continuously. First, the procedure for inserting the urethra indwelling device 1 into the urethra and placing it in place will be described.

At the time of insertion, the user inserts the bladder portion 11 of the urethral stent 10 into the external urethral opening E at the entrance of the urethra, and subsequently removes the urethral stent 10 so that the entire urethral stent 10 enters the urethra. Then I push it deep.

With the entire urethral stent 10 in the urethra, the bladder 11 is still located in the pendulum urethra D. From this state, the user moves the urethral stent 10 to the back of the urethra by pressing the portion of the bulbar urethral flat portion 26 mainly from the outside of the penis with milking so as to narrow it from the outside of the penis.

Thereby, the bladder portion 11 at the tip is pushed from the bulb portion urethra C into the prostatic portion urethra portion B sequentially. Here, since the urethra is narrow and tightened and the urethra is curved from the bulb urethra C to the prostatic urethra B, the outer urinary sphincter muscle K needs to be pushed carefully.

As described above, in the present embodiment, the bladder portion 11 at the tip is curved at about 45 ° with respect to the prostate portion 15, and the curved bladder portion 11 and the

flat projections

16, 17, 26 are in the same plane. It is above.

Therefore, the user bends the urethral stent 10 while maintaining the posture of the urethral stent 10 so that the

flat projections

16, 17 and 26 are in the vertical state, and the curving direction of the urethra at the external urethral sphincter muscle K and The bending direction of the urethral stent 10 matches, and the bladder 11 smoothly enters the prostate urethral area B.

Subsequently, when passing the portion of the external urethral sphincter muscle K to the second prostatic flat projection portion 17, it is necessary for the user to push the urethral stent 10 a little more strongly. Also, when the bladder 11 passes through the prostate urethra B and passes through the internal urethral sphincter muscle J located at the entrance of the bladder A, and the first prostate flat projection 16 passes through the portion of the external urethral sphincter K At this time, the user needs to push in the urethral stent 10 more strongly because the timing is substantially the same.

When the first prostatic flat projection 16 passes the external urinary sphincter K, the bulbar urethral flat part 26 of the bulb urethral part 25 is located outside the external urinary sphincter K, so the external urinary sphincter K is It will be in the state pinched | interposed between the prostatic flat protrusion part 16 and the bulb | ball part urethral flat protrusion part 26. FIG. This state shown in FIG. 3 is the indwelling state of the urethral stent 10 in the urethra.

On the other hand, when the urethral stent 10 is inserted into the urethra and pushed backward, the auxiliary tip 30 is pulled by the connecting cord 40 and drawn to the external urethral opening. The auxiliary tip 30 located at the external urethral opening is pulled by the connecting cord 40 and directly advances into the urethra when the urethral stent 10 is pushed further into the back by the milking, but the user manually separates the auxiliary tip 30 by hand. It may be inserted inside.

The auxiliary tip 30 which has entered the urethra is pulled through the connecting cord 40 as the urethral stent 10 is pushed back, and in the indwelling state described above, the auxiliary tip 30 is a boundary between the bulb urethra C and the pendulum urethra D It is located around.

In this indwelling state, when the urethral stent 10 tries to move backward, the bulbous urethral flat portion 26 can not easily move by colliding with the external urethral sphincter muscle K, and if it tries to pull forward, the first prostate As the flat projection 16 collides with the external urethral sphincter K, the curved tip bladder portion 11 collides with the internal urethral sphincter J and can not move easily either.

That is, the indwelling urethral stent 10 does not move easily in the urethra and becomes stable. For example, the urethral stent 10 is not easily pushed out even if a force acts in a direction to push it out of the urethral stent 10 by urine flowing out of the urethra during urination.

Then, in the indwelling state, the first prostate flat projection 16 and the second prostate flat projection 17 are located in the prostate urethra B, and the prostate urethra B is expanded to ensure the passage of urine reliably. it can.

Here, as in the conventional hollow tubular stent, when the prostate urethra B is spread in all radial directions, the user feels a sense of oppression and a large burden is placed on the user. Since the

projections

16 and 17 for spreading B are flat projections, the load on the user can be reliably reduced while the burden on the user is significantly reduced compared to the case where the prostate urethra B is expanded in all directions. It can be secured.

Further, in the present embodiment, in the indwelling state, the second prostate is located at a distance of 3 mm to the deep urethra of the first prostatic flat projection 16 that spreads the urethra at the end of the prostatic urethra B on the external urethral sphincter K side. The flat projection 17 is located and also spreads the urethra.

The outlet of the ejaculatory tube L connected to the seminal vesicle is located in a seminiferous tubule about 10 mm away from the outlet end of the prostatic urethra B, and in the indwelling state, the first prostate flat projection 16 and the second The outlet of the ejaculatory tube L is located in the space between the prostatic protuberance 17 and the inner wall of the urethra. Therefore, it is possible to relieve the physical load on the user without wearing the urethral stent 10 and blocking the outlet of the ejaculation tube L.

Subsequently, a procedure for taking out the urethral indwelling device 1 in the indwelling state will be described. In the indwelling state shown in FIG. 3, the bulb portion urethra flat protrusion 26 located on the most outlet side of the urethra is deeply pushed to a position closely adhering to the external urethral sphincter muscle K, and the bulb portion urethra flat protrusion 26 is It is difficult to push it to the outlet side of the

Therefore, the user pushes the auxiliary tip 30 located around the boundary between the bulb urethra C and the pendulum urethra D toward the outlet side by milking, and the urethral stent 10 is also pulled through the connecting cord 40 and the urethra is removed. Move to the exit side of the After the auxiliary tip 30 comes out of the urethra, the urethral stent 10 can be pulled out directly from the urethra outlet by pulling the connecting cord 40.

As mentioned above, although this embodiment was described in detail, according to this embodiment, since the structure of the urethra indwelling tool 1 is simple, and the insertion method to the urethra and the removal method from the urethra are also simple, special skills It is possible for a general user to place the urethral indwelling device 1 in the urethra or to take it out of the urethra.

In addition, the urethra indwelling device 1 is provided with an auxiliary tip 30 connected to the urethral stent 10 by a connecting cord 40. This auxiliary tip 30 is positioned around the boundary between the bulb urethra C and the pendulum urethra D when indwelling. Therefore, the urethral stent 10 indwelled in the urethra can be prevented from coming out during urination or the like, and when the urethral indwelling device 1 is taken out, the urethral stent 10 can be removed using the auxiliary tip 30. By pulling, it is possible to easily remove the urethral stent 10.

Further, since the connecting cord 40 is integrally connected by extending the inside of the urethral stent 10 and the auxiliary tip 30, even if the urethral stent 10 or the auxiliary tip 30 is broken in the urethra Since the fragments are connected by the connecting cord 40, the fragments can be easily removed from the body.

In the urethral stent 10, the three

flat projections

16, 17, 26 are located on the same plane, and the surface of the bladder 11 and the bulb urethral section 25 are also located on the

flat projections

16, 17, 26. Since the user curves on the same surface, the user can easily grasp the bending direction of the bladder 11 and the like by touching the

flat projections

16, 17 and 26 when the user milks. That is, the user can easily grasp the posture of the urethral stent 10 at the time of milking, and the insertion into the urethra can be easily performed.

Then, the modification 1 of this embodiment is demonstrated. FIG. 4 is a plan view of the auxiliary chip according to the first modification. The present modification 1 is characterized in that a stick-like auxiliary chip 30 'is adopted instead of the auxiliary chip 30 according to the above-described embodiment, and a locking ring 35 is further provided on the root side of the auxiliary chip 30'.

The auxiliary tip 30 ′ is a silicon rod-like member, and is inserted into the urethra in the same manner as the auxiliary tip 30. The locking ring 35 is made of a silicone material waterproofed on the surface of a stocking material, and has high stretchability.

The locking ring 35 is used by being hooked to the glans margin during placement of the urethral stent 10 and the auxiliary tip 30 'in the urethra. Thereby, it is possible to prevent the urethral stent 10 from entering the depths of the urethra, and to pull the locking ring 35 located outside the urethra even when removing the urethral stent 10 and the auxiliary tip 30 '. Can be pulled out easily.

Then, the modification 2 of this embodiment is demonstrated. FIG. 5 is a plan view of a urethral stent 10 'according to the second modification. In the second modification, instead of the urethral stent 10 according to the above embodiment, a urethral stent 10 'having a different shape is adopted.

The urethral stent 10 'is similar in shape to the urethral stent 10 except that it has no bladder, and includes a prostate 15', a sphincter 21 'and a bulb urethral 25'. The prostate 15 'includes a first prostatic protuberance 16', a second prostatic protuberance 17 ', and a thin rod 18', and the bulbous urethral 25 'comprises a bulbous urethral flat protuberance 26'. Equipped with '.

According to the second modification, since the tip has a simple structure that does not reach the bladder, the psychological hurdle when using the urethra indwelling device 1 is lowered while obtaining the effect of expanding the prostatic urethra B. Even beginners can use it freely.

Then, the modification 3 of this embodiment is demonstrated. FIG. 6 is a view showing the indwelling state of the urethra indwelling device 1 'according to the third modification. The urethral indwelling device 1 ′ adopts a longer connecting cord 40 ′ and extends the connecting cord 40 ′ to the side opposite to the urethral stent 10 of the auxiliary tip 30 ′ ′ and further adds a small tip 31 at its tip. It is characterized by having installed. The auxiliary chip 10 'according to the third modification is the same as the second modification.

Therefore, in the indwelling state of the urethra indwelling device 1 ′, the auxiliary tip 30 ′ ′ is located near the external urethral opening E, which is an outlet in the urethra, and is larger than the auxiliary tip 30 ′ ′ of the connecting cord 40 ′. The portion and the tip 31 always come out of the urethra. According to this modification, it is possible to easily pull out the urethral stent and the auxiliary tip from the urethra.

As mentioned above, although embodiment of this invention was described also including a modification, embodiment of this invention is not limited to the said embodiment, A various deformation | transformation is possible in the range which does not deviate from the main point of this invention It is. For example, the material, shape, size, etc. of the members constituting the urethral indwelling device can be changed as appropriate, and in particular, the shapes and sizes of the bladder, prostate, sphincter and bulb urethral parts of the urethral stent depend on individual differences. It may be changed as appropriate.

Moreover, in the said embodiment, although the epoxy resin is employ | adopted as a material of a urethral stent and an auxiliary tip, resin other than an epoxy may be employ | adopted and materials other than resin may be used. For example, it may be a glass urethral stent. However, in consideration of manufacturing cost and strength, it is desirable that the urethral stent and the auxiliary tip be integrally formed of the same material.

When glass is used as the material, it is difficult to pass the connecting string integrally inside because the temperature is high when forming the glass, so the connecting string may be attached to the surface of the urethral stent and the auxiliary tip. good.

Moreover, when sticking a connection string, a connection string can be fixed firmly by sticking the thing which was united through the connection string inside the sheet | seat of an epoxy resin on the surface of glass. In addition, as a method of fixing the connecting cord, a hole may be formed in the urethral stent, and the hole may be connected through the connecting cord.

Further, in the above embodiment, although the two protuberances, ie, the first prostatic protuberance and the second prostatic protuberance, are provided in the prostatic part of the urethral stent, only the first prostatic protuberance may be provided. In addition, the flat projections of the prostate and the bulb urethra may not have a flat shape, but may have a rod-like shape, for example. It is sufficient that the projection has a shape that can ensure the

DESCRIPTION OF SYMBOLS 1 urethral indwelling device 10 urethral stent 11 bladder 15 prostate portion 16 first prostate flat projection 17 second prostate flat projection 18 thin rod 21 sphincter 25 ball portion urethral 26 ball portion urethra flat projection 30 auxiliary tip 35 Locking ring 40 Connecting cord A Bladder B Prostate urethra C Ball part urethra D Pendulum urethra E Outer urethral opening J Inner urethral sphincter K Outer urethral sphincter L Ejaculation tube

Claims

In the case of a thin rod-shaped urethral stent which is placed in the urethra and spreads the prostatic urethra,
At least a prostate, a sphincter muscle, and a bulb urethral part, which are integrally formed in order from the distal end side,
The prostate portion is a protrusion formed at a boundary with the sphincter muscle portion, and includes a prostate protrusion which forms a gap between the inner wall of the urethra and the prostate portion when indwelling.
The urethral stent according to claim 1, wherein the bulb urethra comprises a bulb urethra formed at a boundary with the sphincter.
The urethral stent according to claim 1, wherein the prostate part, the sphincter part and the bulbous urethral part are integrally formed of the same material.
The urethral stent according to claim 1 or 2, wherein the prostatic protrusion and the bulbous urethral protrusion are flat protrusions.
The urethral stent according to claim 3, wherein the prostatic protrusion and the bulbous urethra are located on the same plane.
The prostate is formed at a predetermined distance on the tip side from the prostatic protrusion at a predetermined distance on the same plane, and a gap is formed between the inner wall of the urethra at the time of indwelling and the prostate. 5. The urethral stent according to claim 4, further comprising a second prostatic protuberance forming the.
The urethral stent according to any one of claims 1 to 5.
An auxiliary tip placed in the urethra at an outlet side of the urethral stent to prevent the urethral stent from coming out of the urethra;
A connecting cord connecting the urethral stent and the auxiliary tip;
A urethral indwelling device characterized by comprising:
7. The urethral indwelling device according to claim 6, wherein the connecting cord is integrally fixed to the urethral stent and the auxiliary tip in a state where the insides of the urethral stent and the auxiliary tip extend over substantially the entire length. .