WO2019069565A1 - Dispositif urétral à demeure - Google Patents

Dispositif urétral à demeure Download PDF

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Publication number
WO2019069565A1
WO2019069565A1 PCT/JP2018/030521 JP2018030521W WO2019069565A1 WO 2019069565 A1 WO2019069565 A1 WO 2019069565A1 JP 2018030521 W JP2018030521 W JP 2018030521W WO 2019069565 A1 WO2019069565 A1 WO 2019069565A1
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WO
WIPO (PCT)
Prior art keywords
urethra
urethral
prostate
urethral stent
prostatic
Prior art date
Application number
PCT/JP2018/030521
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English (en)
Japanese (ja)
Inventor
岡田司郎
Original Assignee
株式会社岡田快適生活研究所
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 株式会社岡田快適生活研究所 filed Critical 株式会社岡田快適生活研究所
Publication of WO2019069565A1 publication Critical patent/WO2019069565A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts

Definitions

  • the present invention relates to a urethral indwelling device to be indwelled in the urethra.
  • treatment is performed in which a urethral stent for expanding the urethra is placed in the urethra.
  • 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.
  • the urethral indwelling device 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.
  • 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.
  • 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.
  • the urethral stent 10 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
  • 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.
  • 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.
  • the bladder 11 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.
  • 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.
  • 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.
  • the bladder 11 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.
  • the bladder portion 11 at the tip is pushed from the bulb portion urethra C into the prostatic portion urethra portion B sequentially.
  • 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.
  • 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.
  • 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.
  • FIG. 3 This state shown in FIG. 3 is the indwelling state of the urethral stent 10 in the urethra.
  • 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.
  • 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.
  • the indwelling urethral stent 10 does not move easily in the urethra and becomes stable.
  • 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.
  • 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.
  • 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.
  • the second prostate in the indwelling state, 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.
  • 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.
  • the urethral stent 10 can be pulled out directly from the urethra outlet by pulling the connecting cord 40.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • FIG. 5 is a plan view of a urethral stent 10 'according to the second modification.
  • 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 '.
  • the tip 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • the epoxy resin is employ
  • resin other than an epoxy may be employ
  • it may be a glass urethral stent.
  • the connecting string 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.
  • connection string 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
  • a hole may be formed in the urethral stent, and the hole may be connected through the connecting cord.
  • the two protuberances ie, the first prostatic protuberance and the second prostatic protuberance
  • the first prostatic protuberance may be provided in the prostatic part of the urethral stent
  • only the first prostatic protuberance may be provided.
  • 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

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (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)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Abstract

Le problème décrit par la présente invention est de fournir un dispositif urétral à demeure de structure simple et qui facilite l'introduction du dispositif dans l'urètre et son retrait hors de l'urètre par l'utilisateur lui-même. La solution selon l'invention porte sur un dispositif urétral à demeure (1) qui est pourvu d'une endoprothèse urétrale (10), d'une extrémité auxiliaire (30) et d'un cordon de raccordement (40) pour raccorder l'endoprothèse urétrale (10) et l'extrémité auxiliaire (30), l'endoprothèse urétrale (10) étant au moins pourvue d'une partie prostate (15), d'une partie sphincter (21) et d'une partie urètre bulbaire (25) qui sont formées d'un seul tenant, dans cet ordre, à partir du côté d'extrémité avant ; la partie prostate (15) est pourvue de sections de projection de prostate (16, 17) qui sont des saillies formées au niveau de la limite avec la partie sphincter (21) et qui forment un espace entre la partie prostate (15) et la paroi interne de l'urètre lorsque le dispositif est installé à demeure ; et la partie urètre bulbaire (25) est pourvue d'une section de projection d'urètre bulbaire (26) qui est formée au niveau de la limite avec la partie sphincter (21).
PCT/JP2018/030521 2017-10-03 2018-08-17 Dispositif urétral à demeure WO2019069565A1 (fr)

Applications Claiming Priority (2)

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JP2017193218 2017-10-03
JP2017-193218 2017-10-03

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WO2019069565A1 true WO2019069565A1 (fr) 2019-04-11

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08322862A (ja) * 1995-06-01 1996-12-10 Honda Seiki Kk 排尿改善用体内留置器具
JP2001218833A (ja) * 2000-02-10 2001-08-14 Sumitomo Bakelite Co Ltd 導尿カテーテル
JP2002085573A (ja) * 2001-08-09 2002-03-26 Sma Medical Inc 尿道ステントの取出方法及び尿道ステント
JP2008541821A (ja) * 2005-05-23 2008-11-27 デボネ、マリアン 前立腺ステントおよびこれを備える取り外し可能なカテーテル装置
JP2009513200A (ja) * 2005-10-29 2009-04-02 ペーエヌエヌ メディカル エスアー 固定部分を有するステント

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08322862A (ja) * 1995-06-01 1996-12-10 Honda Seiki Kk 排尿改善用体内留置器具
JP2001218833A (ja) * 2000-02-10 2001-08-14 Sumitomo Bakelite Co Ltd 導尿カテーテル
JP2002085573A (ja) * 2001-08-09 2002-03-26 Sma Medical Inc 尿道ステントの取出方法及び尿道ステント
JP2008541821A (ja) * 2005-05-23 2008-11-27 デボネ、マリアン 前立腺ステントおよびこれを備える取り外し可能なカテーテル装置
JP2009513200A (ja) * 2005-10-29 2009-04-02 ペーエヌエヌ メディカル エスアー 固定部分を有するステント

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