JPH053314B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to an auxiliary bladder device,
More specifically, we have solved the problem of the inevitable loss of bladder function that occurs when placed in the body like a conventional urinary catheter. The present invention relates to an auxiliary bladder device that can maintain the act of urination.

(Prior Art) Patients who have undergone spinal cord injury, cerebral hemorrhage, encephalomalacia, or surgery, as well as bedridden elderly people, are often accompanied by symptoms such as difficulty in urination and urinary incontinence. In such cases, urinary catheters are widely used to ensure a smooth urinary tract, maintain or improve renal function, or prevent urine leakage.

However, with continuous urinary catheters, which are left in the body for long periods of time like conventional urinary catheters, the bladder is constantly contracted, and the normal urinary function that is inherent in living bodies due to repeated filling and contraction is completely lost. It is becoming. In other words, in the urinary mechanism of a normal person, urine accumulates in the bladder and the bladder wall stretches due to filling, which stimulates the unique receptors that are naturally present in the bladder wall.
Once the stimulus reaches the spinal cord, brainstem, and cerebral micturition center, it then descends from the cerebrum to the spinal cord, causing the bladder wall to contract, relax the pelvic floor muscles, relax the urethral sphincter, and urinate. It's on. In contrast, with conventional continuous catheterization methods for patients with indwelling catheters, the most basic process of urination mechanism, ie, stimulation of receptors by bladder filling due to bladder wall stretching, is missing, so the subsequent urination mechanism stops completely. become a state. In other words, it is no exaggeration to say that it has lost almost 100% of its function as a bladder, and has come to function only as a passageway for urine or a storage area for residual urine.

The following three points have been pointed out as medical or physiological problems caused in such cases. One of these is that with conventional continuous catheterization in patients with catheters, the back base of the bladder becomes a dead space, especially when the patient is in the supine position, so a small amount of urine accumulates, and this residual urine is a perfect breeding ground for bacteria that have entered through the catheter tube. It is a breeding ground for cystitis, pyelonephritis, and even pyelonephritis. Second,
Foley tip necrosis
-crosis), the tip of an indwelling balloon catheter constantly presses against the contracted bladder wall, resulting in ulcers and even necrosis due to poor blood circulation in the area, which in turn becomes infected with bacteria. This is a perfect gateway for entry, and there is a high risk of causing cystitis. Third, as a result of the bladder function completely stopping due to catheter placement, the longer the catheter remains in place, the slower the recovery of bladder function after the catheter is removed. For example, in patients with urinary retention due to neurogenic bladder after spinal cord injury, cerebrovascular disorder, or pelvic surgery, bladder training is started in the subacute stage when the abnormality of urinary function has stabilized, but an indwelling catheter is not used for a long time. It has been pointed out that it is difficult to train for something that has been used for a long time.

In addition, as an alternative method, intermittent urinary catheterization has been recommended in recent years, although it has the disadvantage that it takes much more time and effort than continuous urinary catheterization using a balloon catheter for long-term indwelling. (Self-catheterization) is an example. In this method, a nurse or herself inserts a catheter and urinates several times a day when the bladder is full.

Conventionally, with this method, bacterial infection would soon occur as urine was catheterized many times, and if urine remained in the bladder for a long time, bacteria would multiply during that time, causing pyelonephritis not only in the bladder but also in the upper layer. It has been considered inferior to continuous urinary catheterization because of the high possibility of complications. However, in recent years, if the interval between catheterizations is shortened (preferably within 3 hours, but at the latest within 5 hours) and the urine is completely drained before the bacteria in the bladder proliferates, infection can no longer be detected in the bladder. It has been found that this method is often recommended when urinary catheterization is required for a long period of two weeks or more. This intermittent urinary catheterization method uses the dilution effect of periodically cleaning and draining the bladder with own urine, which is the most physiological fluid, and the natural infection caused by a healthy bladder wall that repeatedly fills and contracts. It is thought that the proliferation of bacteria in the bladder is prevented because it has a self-cleaning effect such as a protective effect. and,
Above all, the advantage of intermittent (self-catheterization) is that it can maintain the body's natural urinary functions of filling and contracting the bladder. Recovery is much faster than with continuous catheterization.

However, as mentioned above, this intermittent urinary catheterization method requires a lot of time and effort, and especially in the sterile intermittent urinary catheterization method, the vulva must be shaved and thoroughly disinfected, and the Urinary drainage cleaning, hands, gloves,
It requires various operations such as disinfecting instruments, washing the bladder several times after catheterization, injecting antibiotics, and finally covering the vulva with a sterile bag or gauze, so it cannot be widely used by the general public. I couldn't reach it.

Therefore, the present inventors first determined that the discharge end of a urinary catheter placed in the bladder was placed in a pressure regulating chamber containing a concentric siphon tube, and that the uppermost end of the inner tube of the concentric siphon tube The pressure regulating chamber and the urine storage chamber provided below the pressure regulating chamber are connected directly or via a connecting pipe between the lowermost ends of the outer tubes of the concentric shaft type siphon tube, and the concentric siphon tube An auxiliary bladder device connected to an inner tube of an axial siphon tube, and provided in the pressure adjustment chamber with a vent sealed with an airflow resistance filter at a position higher than the highest position of the concentric siphon tube. (Japanese Unexamined Patent Publication No. 176661/1983).

This auxiliary bladder device employs an automatic intermittent urinary catheter system that has a concentric siphon tube at the discharge end of the urinary catheter, and by using this system, even when the urinary catheter is indwelling in the bladder. , the bladder repeatedly fills and contracts at regular intervals without the need for complicated operations as in the case of general intermittent urinary catheterization, and the body's natural urinary function is maintained, resulting in self-cleaning and infection prevention. Since the action is carried out automatically, it does not cause bacterial urinary tract infection, and is suitable for bladder function recovery training for patients with urinary retention or urinary incontinence, such as those with spinal cord injuries, those with cerebrovascular disorders, patients after surgery, and bedridden elderly people. It was available for use.

(Problems to be Solved by the Invention) When urinary catheterization is performed for a long time using the auxiliary bladder device of the previous invention, after the siphon flow of urine is completed, the inner wall surface of the inner tube of the siphon tube The attached residual urine becomes a liquid column, and the resulting negative pressure causes the liquid level in the inner and outer tubes of the siphon tube to be higher than the liquid level in the pressure adjustment chamber by the height of the liquid column remaining in the inner tube. Therefore, it has often been observed that before a small amount of urine has accumulated in the patient's bladder, the urine is discharged into the pressure adjustment chamber due to the negative pressure, and the next siphon flow is activated.

If the device of the previous invention were to operate irregularly as described above, it would not be possible to maintain the body's natural urinary function as an auxiliary bladder device, making it unsuitable for training patients to recover their bladder function. It turned out that it could not be called a device.

(Means for Solving the Problems) As a result of intensive studies to solve the above problems, the present inventors have developed a concentric shaft installed in the pressure adjustment chamber in the auxiliary bladder device previously proposed by the applicant. By connecting the lower part of the inner pipe of the type siphon pipe with a communication pipe serving as a branch pipe, and making this communication pipe run along the outside of the outer pipe and opening at a position higher than the top of the siphon pipe, The inventors have found that the problem can be solved and have arrived at the present invention.

That is, the present invention includes a urinary catheter 2 to be placed in the bladder, a pressure adjustment chamber 3, and a urine storage chamber 5, and the pressure adjustment chamber 3 includes an inner tube 11 and an outer tube 12 fitted externally thereto. Concentric shaft type siphon tube 1
0, and the communicating pipe 16, which is a branch pipe connected to the lower part of the inner pipe 11 of the siphon pipe 10, is placed along the outer side of the outer pipe 12 so that the tip thereof is connected to the siphon pipe 1.
A urine storage chamber 5 is provided below the pressure adjustment chamber 3, and the tube is indwelled in the bladder at a position at or below the lowest end of the outer tube 12. urinary catheter 2
The discharge end of is connected to the pressure adjustment chamber 3, and the communication pipe 1
The gist of the present invention is an auxiliary bladder device characterized in that an airflow resistance filter 15 is provided in the pressure adjustment chamber 3 above the pressure adjustment chamber 6.

(Function) The auxiliary bladder device of the present invention operates by connecting a pressure adjustment chamber to a urinary catheter placed in the bladder, and after a certain period of time, when the bladder and pressure adjustment chamber are filled with urine, a siphon flow occurs. begins, and after a certain period of time, the bladder and pressure-regulating chamber are emptied, and the siphon flow stops. At this time, residual urine adhering to the inner wall surface of the inner tube of the siphon tube becomes a liquid column within the inner tube, but the negative pressure generated by this liquid column is immediately transferred from the pressure adjustment chamber, which has the same pressure as the atmosphere, through the communication tube. As air is replenished, the liquid column falls into the urine storage chamber and the negative pressure in the inner tube as well as in the siphon tube is eliminated. From then on, the above cycle will be repeated, and a liquid column of residual urine will no longer occur in the inner tube after siphon flow.
The original operation of the auxiliary bladder device can be repeated smoothly and appropriately.

(Example) An embodiment of the present invention is specifically shown in FIG.

In FIG. 1, 1 is a bladder, 2 is a urinary catheter placed in the bladder, and the catheter 2 is connected to a pressure adjustment chamber 3. This pressure adjustment chamber 3 has a concentric shaft type siphon pipe 10 consisting of an inner pipe 11 of a concentric shaft type siphon pipe 10 and an outer pipe 12 fitted onto the inner pipe 11.
and a communication pipe 16 that is a branch pipe that communicates with the lower part of the inner pipe 11 of the siphon pipe 10 (preferably near the inner bottom of the pressure adjustment chamber 3).
extends downward from the outer tube 12. In this case, a communication pipe 16 whose one end communicates with the lower part of the inner pipe 11
is placed along the outer side of the outer tube 12, and its tip is opened at a position higher than the top of the siphon tube 10.
One end of the communication pipe 16 is connected to the inner pipe 11 below the lower end of the outer pipe 12 in the pressure adjustment chamber 3 .
4 is a tube connecting the urinary catheter 2 and the lower connecting port 3h of the pressure adjustment chamber 3, that is, a connecting pipe. A urine storage chamber 5 is provided below the pressure adjustment chamber 3 and receives urine from the inner tube 11 of the siphon tube 10 through an upper opening. This urine storage chamber 5 includes a siphon pipe 1 that projects and opens at the bottom of the pressure adjustment chamber 3.
It is connected to the pressure adjustment chamber 3 by an inner pipe 11 of 0.0. The urine storage chamber 5 is provided with a bacterial migration prevention device 13 in the receiving section, a vent 6, a sterilization filter 7 provided in the vent 6, an outlet 8 provided at the bottom of the urine storage chamber 5, and a stopper for the outlet 8. ing. The pressure adjustment chamber 3 also includes a vent 14 for discharging and replenishing air by filling and discharging urine in the pressure adjustment chamber 3;
A ventilation resistant filter 15 inserted into the ventilation hole 14
is provided. As the ventilation resistance filter 15, one having an air flow rate of 10 to 20,000 ml/min is preferably used. The air flow rate in this case is 20
It is expressed as the value when particle-free air at ℃ is filtered at a pressure of 0.07 kg/cm ² (1 psl).

In the illustrated example, the discharge end of the urinary catheter 2 is connected to the pressure regulating device 3 via the connecting tube 4, but the urinary catheter 2 may be directly connected to the pressure regulating device 3. In addition, urinary catheter 2
The connection between the pressure adjustment device 3 and the urinary catheter 2
It is preferable that the discharge end of the siphon tube 10 be connected to the same height as the lowermost end of the outer tube 12 of the siphon tube 10 or at a position lower than this.

(Effects of the Invention) According to the auxiliary bladder device of the present invention, by simply placing the urinary catheter in the bladder without using any complicated mechanical or electrical drive or control mechanism, other siphon uses can be performed. This device allows the bladder to smoothly fill and contract repeatedly at regular intervals without causing the irregular siphon flow that occurs with other devices. It is extremely effective when used in patients exhibiting symptoms of urinary incontinence or urinary incontinence, such as bedridden elderly people. For example, when used on spinal cord patients, conventional continuous urinary catheterization required an indwelling catheter for 1 to 2 months, but by using the device of the present invention, there is no urinary tract infection, for example, 2 months. It is also possible to restore bladder function to a state where a catheter is no longer required in as little as a week. The device of the present invention is thus highly effective in terms of rehabilitation.

[Brief explanation of the drawing]

FIG. 1 is a schematic side view showing the overall positional relationship of an embodiment of the auxiliary bladder device of the present invention. 1... Bladder, 2... Urinary catheter, 3... Pressure adjustment chamber, 3h... Lower connecting port, 4... Connecting tube,
5... Urine storage room, 6, 14... Ventilation port, 7... Sterilization filter, 8... Outlet, 9... Stopper,
10...Concentric shaft type siphon pipe, 11...Inner pipe, 1
2... Outer tube, 13... Bacteria migration prevention device, 15...
...Airflow resistance filter, 16...Communication pipe.

Claims (1)

[Claims] 1 A concentric shaft type siphon comprising a urinary catheter 2 to be placed in the bladder, a pressure adjustment chamber 3 and a urine storage chamber 5, and inside the pressure adjustment chamber 3, an inner tube 11 and an outer tube 12 fitted externally to the inner tube 11 are provided. A pipe 10 is provided, and a communication pipe 16 which is a branch pipe communicated with the lower part of the inner pipe 11 of the siphon pipe 10 is placed along the outer side of the outer pipe 12 so that its tip is positioned higher than the top of the siphon pipe 10. A urine storage chamber 5 is connected below the pressure adjustment chamber 3, and the discharge end of the urinary catheter 2 indwelled in the bladder is connected to the pressure adjustment chamber 3. An auxiliary bladder device characterized in that a pressure regulating chamber 3 is provided with a ventilation resistant filter 15 at the upper side.