KR102716112B1 - An implantable urethral support device for the treatment of urinary incontinence - Google Patents

Abstract

The present invention relates to an implantable urethral support device for treating urinary incontinence, and more specifically, to a urethral support device configured such that two spaced-apart fixed body parts are arranged to form an angle with each other, and the two fixed body parts are connected at two points, namely the urethral support part and the body connection part, so as to be stably seated on the posterior surface of the pubic bones forming the pubic symphysis, wherein under downward pressure from abdominal pressure, the fixed body parts and the body connection part are supported by the pubic bone, resisting the downward pressure, while the descending urethra is supported by the upper urethral support part, causing a bend above the urethral support part to prevent urinary incontinence due to rapid urethral closure.

Description

{An implantable urethral support device for the treatment of urinary incontinence}

The present invention relates to an implantable urethral support device for treating urinary incontinence, and more specifically, to a device in which two fixed body parts on the left and right sides are spaced apart and arranged to form an angle with respect to each other, and the two fixed body parts are connected through two points, such as a urethral support part and a body connection part, to be stably secured on the back of both pubic bones forming the pubic symphysis.

This relates to a urethral support device for treating urinary incontinence, in which a fixed body part and a body connection part are supported by the pubic bone when there is downward pressure of abdominal pressure to resist downward pressure, and a descending urethra is supported by an upper urethral support part so that a bend occurs above the urethral support part to rapidly close the urethra and prevent urinary incontinence.

Urinary incontinence is the unintentional leakage of urine when abdominal pressure suddenly increases, such as when exercising, laughing, or coughing. It occurs when the pelvic floor muscles that support the pelvic floor and the ligaments that support the urethra are weakened.

Causes include increasing age, pregnancy, childbirth, chronic cough or asthma, and intense exercise, and it can also become worse with obesity or menopause.

Referring to Figure 6,

The pelvic floor muscles are various muscles (PCM, LMA, LP) that support the organs in the female pelvis and make up the pelvic floor. Weakened pelvic floor muscles are in a relaxed state, and are easily pushed downward during coughing or exercise that increases abdominal pressure.

The pelvic floor muscles, which are pulled downward, pull the bladder and urethra downward, and this force acts to open the urethra.

A weakened pubourethral ligament has less power to oppose this force and becomes relaxed, which should cause urethral bending and urethral obstruction when the bladder and urethra move posteriorly above the pubourethral support due to the supporting force of the ligament. However, this does not happen, resulting in urinary incontinence.

This mechanism is the Integral theory, which is currently the most widely accepted, and is different from the existing theory that urinary incontinence is caused simply by the pressure difference between the bladder and urethra.

Based on this, there are non-surgical methods such as Kegel exercises that strengthen weakened pelvic floor muscles and treat urinary incontinence by reducing the downward movement of the pelvic floor muscles by resisting abdominal pressure.

Surgical methods that support the urethra by fixing artificial tape to human structures instead of weakened ligaments are currently the main method of urinary incontinence surgery. For this reason, various surgical methods have been developed to support the urethra by fixing artificial tape to the obturator fascia located in the obturator foramen of the pelvis, which is close to the urethra and has excellent fixation strength.

The urethra, supported by an artificial tape inserted in various ways and fixed to the obturator fascia, can resist the force generated by the pelvic floor muscles, preventing the urethra from opening, and by opposing the force pulling the bladder and urethra downward, the urethra bends above the artificial tape, causing urethral obstruction and treatment.

As referenced in Fig. 7,

The recent Trans-Obturator Tape (TOT) surgical technique, a method for treating urinary incontinence, involves making an incision in the inguinal region and in the suburethra, and then passing a guide needle holder from the inguinal region through the obturator foramen to create a passage below the urethra.

Afterwards, the prolene mesh tape is hung on a holder under the urethra (or in reverse order) and pulled toward the inguinal region, fixing the tape to the obturator fascia to support the lower part of the urethra, thereby treating urinary incontinence. (Afterwards, the tape is cut under the skin so that it is not exposed under the skin or vaginal mucosa, and the skin and urethral mucosa are sutured, respectively.)

In the case of the Minisling method, which is called a single-port surgery method by only making a suburethral incision in contrast to the TOT of suburethral incision and inguinal incision, a method is performed by directly inserting and fixing a tape to the obturator fascia through a guide needle holder from the suburethra to the obturator fascia after the suburethral incision.

However, although these recent treatments are the least invasive methods available, they usually require spinal anesthesia or general anesthesia, and damage to the muscles and ligaments and blood vessels in the inguinal region → obturator foramen → urethra frequently occurs during the process of creating a passage using instruments.

In addition, there is the inconvenience of the artificial tape adhering to human tissue after surgery, making reoperation difficult and making it impossible to remove all of the inserted tape.

Korean Patent Registration No. 10-0947552 (registered on March 8, 2010; hereinafter referred to as “Prior Document 1”) proposes a pressure conversion tension device for treating urinary incontinence.

The above prior art document 1 provides a structure in which elastic parts at both ends are inserted into the recessed space formed on both sides of the upper part of the urethra to fix the position, and the support part formed between the two elastic parts is provided in the form of a bag located in the lower part of the urethra, so that when the recessed space is reduced due to increased abdominal pressure, the volume of the elastic part is reduced, and the internal fluid is concentrated in the support part to expand the support part and compress the urethra.

Korean Patent No. 10-1063358 (registered on September 1, 2011; hereinafter referred to as “prior document 2”) proposes a closed-loop tension conversion device.

The above prior art document 2 provides a structure in which a urethra support shape part rotates around the two urethra support shape parts when abdominal pressure is applied by fixing the position by inserting the urethra support shape part into the urethra support shape part formed on both sides of the urethra.

Korean Patent No. 10-1461492 (registered on November 7, 2014; hereinafter referred to as “prior document 3”) proposes a urethral compression tension device for treating urinary incontinence.

The above prior art document 3 is composed of a compression part placed on both sides or the upper side of the urethra and a connecting part passing through the lower part of the urethra to connect the two compression parts, and when abdominal pressure is applied, the connecting part rotates around the compression part to pressurize the lower part of the urethra, thereby achieving urethral closure.

All of the above-mentioned prior documents 1 to 3 utilize the Rezzi space, which is a space formed between the pelvic bone and the bladder by elastic tissue around the bladder and urethra.

It has been known that the Rezzi space reduces friction between the bladder and its surroundings, and when abdominal pressure increases, the abdominal pressure is directly transmitted to the urethra through the Rezzi space, preventing pressure reduction by tissues, thereby increasing the urethral closure pressure and preventing urinary incontinence.

However, its meaning has faded as it is now known that the cause of urinary incontinence is not a problem caused by the difference between bladder pressure and urethral pressure due to increased bladder pressure, but rather that urine leakage is caused by weakened pelvic floor muscles and urethral supporting ligaments preventing urethral bending and resulting urethral obstruction.

These rezz space not only differ from person to person, but also allow the urethral support device to rotate easily due to spatial limitations formed by elastic tissue. However, since the downward support force due to tissue elasticity is not sufficient, the device is pushed downward and rotational movement occurs, so a constant rotation radius is not formed centered on the rezz space.

In addition, if the device is not positioned correctly but is positioned obliquely or twisted due to the crowding of the urethra and surrounding tissues, the axis of rotation may be misaligned, making it difficult to accurately support the urethra each time abdominal pressure is applied, and a gap may be formed unintentionally between the device and the urethra, which may cause urine to leak.

For the above reasons, if the abdominal pressure is not converted into a supporting force that evenly supports the urethra through the device, problems may occur, such as the inserted device physically damaging the vaginal mucosa and falling out of the body.

Therefore, research became necessary on a new structure that could support the urethra stably when abdominal pressure occurs and solve the problem of urinary incontinence while allowing insertion of a urethral support with a simple procedure.

Korean Patent No. 10-0947552 (registered on March 8, 2010): Pressure conversion tension device for treating urinary incontinence Korean Patent No. 10-1063358 (registered on September 1, 2011): Closed-air tension conversion device Korean Patent No. 10-1461492 (registered on November 7, 2014): Urethral compression tension device for treating urinary incontinence

The urethral support device for treating urinary incontinence of the present invention, which aims to solve the problems of the prior art as described above,

The purpose of this invention is to provide a device having a structure that is installed on the back of the pubic bone on both sides forming the pubic symphysis, thereby providing direct support for the downward pressure of the abdomen through the pubic bone, while minimizing twisting and tissue damage by the surrounding tissue.

In addition, another purpose is to provide a device that can be placed close to the urethra to quickly support the urethra when abdominal pressure occurs, thereby achieving urethral closure and suppressing urinary incontinence.

The urethral support device for treating urinary incontinence of the present invention to solve the above problems is:

A urethral support device for the treatment of urinary incontinence, which is installed inside the human body and supports the urethra that descends when abdominal pressure is applied to close the urethra, comprises: a fixed body part that is arranged at a predetermined distance on the left and right sides of the urethra and is placed on the back of the pubic bones on both sides forming the pubic symphysis; a urethral support part that connects the upper portions of the spaced-apart left and right fixed body parts to support the back of the urethra arranged on the inside while supporting the urethra that sags posteriorly when abdominal pressure is applied to close the urethra by bending the urethra; and a body connection part that supports the back of the urethra arranged on the inside of the spaced-apart left and right fixed body parts and connects the left and right fixed body parts at the lower portion of the urethral support part to prevent twisting of the left and right fixed body parts and to help secure the device on the back of the pubic bone.

The above fixed body part can be directly vertically connected while protruding forward from the urethra support part and the body connection part so that it can be stably settled on the back of the pubic bone. In addition, it can be vertically connected at the extended portion after extending laterally from the urethra support part and the body connection part, respectively. In addition, it can be stably settled on the back of the pubic bone by protruding forward. The auxiliary frame can be connected vertically with an expanded surface wider than the urethral support part and the body connection part or with a hole formed on the inside to form an integral connection.

Here, the surface formed by the extended portions on both sides or the extended surfaces of the two fixed body parts can be arranged to form an angle of less than 45 degrees to less than 180 degrees.

Additionally, the above body connecting portion may be formed in one or more parts.

In addition, the above urethral support portion and the body connecting portion may be connected as one in whole or in part, and the connected portion may be formed as a surface to support the rear of the urethra.

In addition, the urethral support part can be formed by connecting backwards through the upper ends of the left and right fixed body parts, and the body connection part can be formed by connecting backwards through the lower ends of the left and right fixed body parts.

In addition, the urethral support part can be formed by connecting backwards through an upper connection point, which is a point spaced a certain distance from the upper part of the left and right fixed body parts to the midpoint, and the body connection part can be formed by connecting backwards through a lower connection point, which is a point spaced a certain distance from the lower part of the left and right fixed body parts to the midpoint.

In addition, the urethral support portion and the body connection portion may be formed in a form that is extended backwards from the fixed body portion and parallel to each other to form a horizontal arrangement, an upward arrangement, or a downward arrangement, or one or more of them may be extended in different directions to form a cross arrangement, an expanded arrangement, or a tapered arrangement of the two extension portions.

In addition, the urethral support portion and the body connection portion may be respectively connected through the same point of the left and right fixed body portions, and the urethral support portion may be connected so as to be positioned upward, and the fixed body portion may be connected so as to be positioned downward, so as to be positioned so as to spread out vertically from one point.

The urethral support device for treating urinary incontinence of the present invention by the above solution means is,

By arranging the front surface of the protruding fixed body portion at an obtuse or acute angle similar to the angle formed by the back surfaces of the pubic bones on both sides, the contact surface with the pubic bone is maximized, so that it is easily settled on the back surface of the pubic bone, and the lower body connection portion acts as a bridge between the pubic bones on both sides, as if it were fixed to the pelvis, so that it has strong support for the downward pressure generated by abdominal pressure and also provides support for the left-right sliding.

Based on this support, the upper urethral support part enables the urethra to bend and urethra to be closed quickly, and the two fixed bodies connected to each other through multiple points prevent the device from being twisted due to surrounding tissue pushing, etc., and by being stably placed on the back of the pubic bone, the urethra is supported consistently and evenly during abdominal pressure, effectively closing the urethra and preventing urinary incontinence.

In addition, the structure of the present invention can minimize tissue damage caused by pressure applied unevenly to the device by efficiently dispersing and evenly offsetting abdominal pressure.

In addition, the fixed body parts can be advanced further forward than when they are arranged at a 180° left-right vertical angle due to the angle of the two fixed body parts being bent, allowing the urethral support part to be placed closer to the urethra, and the closely placed urethral support part shortens the time it takes for the urethra to bend when abdominal pressure is generated, providing the effect of rapid urethral closure.

In addition, since the urethral support device of the present invention does not bio-bond with human tissue, re-operation can be performed simply, so that device replacement can be easily performed, and by using a suture that passes through an auxiliary frame hole to suture adjacent tissue, the position can be firmly fixed, thereby providing a useful device that can be operated in various ways.

FIGS. 1A to 1D are a perspective view, a front view, a plan view, and a side view illustrating a urethral support device for treating urinary incontinence according to a preferred embodiment of the present invention.
FIGS. 1e and 1f are perspective views illustrating a urethral support device configured in a frame shape according to the present invention.
FIGS. 2A and 2B are horizontal and vertical cross-sectional layout diagrams schematically illustrating a state in which a urethral support device according to a preferred embodiment of the present invention is secured to the posterior surface of the pubic bone.
Figure 3 is a side view showing various forms in which the urethra support unit and the body connection unit are respectively connected through the upper and lower parts of the left and right fixed body parts of the urethra support device according to the present invention.
FIG. 4 is a side view showing various forms in which the urethra support unit and the body connection unit are each connected through points spaced apart at a certain distance from the top and bottom of the left and right fixed body units of the urethra support device according to the present invention.
Figure 5 is a side view showing another form of the urethra support part and the body connection part connecting the left and right fixed body parts of the urethra support device according to the present invention.
Figure 6 is a schematic diagram showing the movement of organs in the female pelvis.
Figure 7 is a drawing showing the installation status and surgical tools according to the TOT method and the Mini-sling method among conventional urinary incontinence treatment methods.

Hereinafter, embodiments of the present invention will be described in detail with reference to the attached drawings. The present invention can be modified in various ways and can have various forms, and specific embodiments are illustrated in the drawings and the present invention will be described in detail in the text. However, this is not intended to limit the present invention to a specific disclosed form, but should be understood to include all modifications, equivalents, or substitutes included in the spirit and technical scope of the present invention. In describing each drawing, similar reference numerals are used for similar components. In the attached drawings, the dimensions of structures are illustrated enlarged or reduced from the actual size in order to ensure clarity of the present invention.

The terminology used in this application is only used to describe specific embodiments and is not intended to limit the present invention. The singular expression includes the plural expression unless the context clearly indicates otherwise. In this application, it should be understood that the terms "comprises," "includes," or "has" are intended to specify the presence of a feature, number, step, operation, component, or combination thereof described in the specification, but do not exclude in advance the possibility of the presence or addition of one or more other features, numbers, steps, operations, components, or combinations thereof.

Unless otherwise defined, all terms used herein, including technical or scientific terms, have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Terms commonly used and defined in dictionaries, such as those defined in general, should be interpreted as having a meaning consistent with the meaning they have in the context of the relevant art, and will not be interpreted in an idealized or overly formal sense unless explicitly defined in this application.

FIGS. 1A to 1D are a perspective view, a front view, a plan view, and a side view illustrating a urethral support device for treating urinary incontinence according to a preferred embodiment of the present invention.

As mentioned above, the urethra support device (10) according to the present invention comprises a pair of fixed body parts (20) spaced apart from each other on the left and right sides of the urethra and each placed on the lower part of the posterior surface of the pubic bone, which is the posterior surface of the body cavity near the pubic symphysis of the pubic bones forming the pelvis, a urethra support part (30) that connects the upper parts of the spaced-apart left and right fixed body parts and supports the posterior part of the urethra that is arranged on the inside, and one or more body connection parts (40) that connect the left and right fixed body parts at the lower part of the urethra support part and supports the posterior part of the urethra that is arranged on the inside.

The above fixed body part (20) is a member that is formed long vertically and protrudes forward.

The above protrusion may be provided in the form of a projection or in the form of a long member being bent into an arch shape, and may also include protrusions formed in various shapes such as a wedge shape.

In addition, if the above-mentioned long member is bent into an arch shape, a certain amount of elastic deformation can be achieved to cushion pressure applied in the up-down direction, thereby preventing damage to body tissue caused by strong rebound pressure.

In addition, the protruding front surface (21) of the fixed body part can be expanded to form a wider surface of the urethral support part or the body connecting part, and the expansion can be formed as a plane or a gentle surface that is a straight line or a gentle curve in the left-right width direction.

In addition, as shown in FIG. 1e, a fixed body part may be formed through a diameter identical or similar to that of the urethral support part and the body connecting part, and an auxiliary frame may be further connected to the side of the fixed body part to form an extended surface having a through hole therein.

By providing the fixed body part as an extended surface in this way, stable support can be achieved by making contact with the posterior surface of the pubic bone in a line or surface.

In addition, the fixed body part (20) can be gently processed so that no edges are created when inserted into the human body, thereby preventing damage to human tissue.

The fixed body part (20) having this structure is composed of two parts spaced apart at a certain distance on the left and right and is placed in the inner space of the pelvis.

More specifically, it is installed on the back of the pubic bone on both sides of the pubic symphysis that constitutes the pelvis, especially on the back of the pubic bone on both sides of the subpubic angle close to the pubic symphysis, to provide fixation in the left-right and up-down directions.

The above urethral support part (30) connects the upper parts of the left and right fixed body parts (20) that are spaced apart.

The urethral support member (30) is integrally connected to the rear of the left and right fixed body members, with both ends facing forward.

As shown in Fig. 1c, the urethral support member (30) extends from the rear of one fixed body part to the rear side and is bent into a U shape to be connected to the other fixed body part.

The above urethral support member (30) has a receiving groove (31) or receiving space formed on the inside by the bending, and when the urethra is placed in the receiving groove and abdominal pressure is generated, the urethra sagging shape is generated in various directions in the side and rear, and at this time, the urethral support member placed in the rear of the urethra can quickly support the lower part of the urethra to achieve urethral closure by urethral bending.

Since these receiving grooves (31) accommodate the urethra inside even when twisting occurs in the urethra support device of the present invention, they can provide the effect of supporting the urethra when abdominal pressure occurs, thereby achieving urethral closure.

The above urethral support member can be provided in various shapes other than a U-shape that can include the urethra, and the surface in contact with the urethra can be formed as a curved surface to prevent the urethra from being damaged during the support process.

In addition, as shown in FIG. 1d, the urethral support member (30) can support the part of the urethra close to the bladder by forming the middle bent part upward, thereby allowing urethral closure.

Here, the urethral support member can be formed to protrude upward, horizontally, or downward in whole or in part, and can be provided in various forms, such as protruding in a straight line or in a curved shape.

By blocking the urethra in this way at a point close to the bladder, urine can be prevented from flowing into the urethra from the bladder.

In addition, the connection between the urethral support part (30) and the fixed body part (20) is tapered from the fixed body part (20) with a wide cross-section toward the urethral support part (30) with a narrow cross-section, so that urethral support can be achieved without damage to the urethra due to corners or steps.

The above body connection part (40) is a part that connects the left and right fixed body parts (20) at the lower side of the urethral support part (30).

The above body connection part can also be connected in a straight line similar to the urethral support part, or connected while protruding and bending backwards in a U shape, and is configured to be connected in a tapered manner to the fixed body part.

The above body connecting portion, together with the fixed body portion, widens the contact surface at the lower posterior end of the pubic bone, acts as a bridge between the pubic bones on both sides, and plays a role in being fixed and secured at the rear of the pubic bone, thereby strengthening the downward support force for the urethral support portion.

The installation on the back of the pubic bone can also be accomplished through the body connection part (40). When the body connection part (40) protrudes rearwardly in an upward or downward direction as shown in Fig. 1d, the overall arrangement of the urethral support device can be formed differently when installed on the back of the pubic bone through the body connection part.

For example, when the body connecting portion is formed to protrude in the upper diagonal direction as in Fig. 1d and installed by fixing the body connecting portion on the back of the pubic bone, the fixed body portion is provided in a form in which the upper side is positioned more posteriorly than the lower side, and the urethral support portion is positioned more posteriorly than the body connecting portion.

In addition, when the body connecting portion is formed to protrude in the lower diagonal direction and installed by settling the body connecting portion on the back of the pubic bone, the fixed body portion is provided in a form in which the upper side is positioned more forward than the lower side, and the urethral support portion is positioned more forward than the body connecting portion.

In addition, when the urethra support device (10) of the present invention is mounted upside down, the existing urethra support part can serve as a body connection part and the existing body connection part can serve as a urethra support part, and the urethra support part can be positioned forward and backward depending on the protruding shape of the urethra support part and the body connection part.

By placing the urethral support member forward, the urethral support device can be placed close to the urethra to provide urethral support without having to be installed deep anteriorly from the posterior surface of the pubic bone.

When the urethral support member is positioned posteriorly, the urethral support device can be pressed against the anterior wall of the pubic bone to provide stable support for vertical pressure.

In addition, the body connecting portion (40) and the urethral support portion (30) may be provided in various lengths, such as being configured to extend backwards with the same length or to extend backwards with different lengths.

The present invention connects the urethra support part (30) and the body connecting part (40) at two upper and lower points on the rear of a pair of left and right fixed body parts (20), thereby maintaining the gap between the two fixed body parts and minimizing distortion.

In addition, the above body connecting parts (40) can be formed in multiple numbers to increase the supporting force of the two fixed body parts and prevent distortion.

In addition, when the urethral support portion and the body connection portion are formed with the same posterior protrusion length, the uppermost portion provides the urethral support and urethral bending urethral support functions, but when only one of the multiple body connection portions has a short posterior protrusion length, the body connection portion with a short length can directly compress the urethra while providing a twist-prevention function, thereby increasing the occlusion pressure of the urethra.

As shown in FIG. 1e, the frame-shaped urethral support device (10a) of the present invention is formed by forming a fixed body portion (20a), a urethral support portion (30a), and a body connection portion (40a), and further extending an auxiliary frame (22) to the side of the fixed body portion so that a through hole (23) is formed. The through hole formed by the auxiliary frame can also be formed in a mesh shape to increase the structural strength of the portion extending from the fixed body portion to the side.

In addition, the frame-shaped fixed body part (20a) according to the present invention may be configured with a side extension part (25) extending laterally from the ends of the upper urethra support part (30a) and the lower body connection part (40a) as shown in FIG. 1e, in addition to a form in which the fixed body part (20a) is vertically directly connected to the upper urethra support part (30a) and the lower body connection part (40a) as shown in FIG. 1f, and a vertical connection part (26) connecting the upper and lower extension parts.

In addition, the expansion surface formed by the fixed body part itself of Fig. 1a being expanded to a wide surface, or the virtual expansion surface formed by the auxiliary frame on the side of the fixed body part of Fig. 1e, or the virtual expansion surface formed by the side extension portions extending laterally on each side of Fig. 1f, can be arranged to form an angle of less than 180 degrees to 45 degrees so that it can be arranged to advance forward when settling on the posterior surface of the pubic bone as described later.

Figures 2a and 2b illustrate a state in which a urethral support device according to the present invention is installed at the lower rear surface of the pubic bone within a human body.

In the above drawings, the upper side of Fig. 2a and the left side of Fig. 2b are the abdominal side, and the lower side of Fig. 2a and the right side of Fig. 2b are the buttocks side, showing the pubic symphysis and both pubic bones, and are perspective and side cross-sectional views of the device placed on the lower posterior surface of the pubic bone from the head toward the legs.

As mentioned above, the urethral support device (10) according to the present invention can have the internal angle formed by the front surface, which is the extended surface of the left and right fixed body parts (20), be within a range of 45 to less than 180°.

The above fixed body parts (20) are arranged on the left and right, respectively, and the inner angle formed by the front surface (21) of each fixed body part (20) is formed similarly to the angle formed by the left and right pubic bones (71) forming the pelvis (70), so that the urethral support device can be moved forward from the back surface of the pubic bone to the front side (x-axis direction) and pressed against the urethra.

This increases the contact area with the pubic bone and is supported by the left and right pubic bones through the body connection, thereby strengthening the downward and left-right support forces, and is less affected by the surrounding tissues and can minimize device deformation due to tissue displacement.

In addition, Fig. 2a illustrates the change in installation position according to the arrangement angle of the left and right fixed body parts (20).

A "dotted line urethral support device (10b)" in which the internal angle formed by the two front surfaces (21) of the left and right fixed body parts is 180°, and a "solid line urethral support device (10a)" in which the internal angle formed by the front surfaces of the left and right fixed body parts is 100° are illustrated.

The above solid line urethral support device (10a) and dotted line urethral support device (10b) are formed identically except for the inner angle of the front surface (21) of the left and right fixed body parts.

As shown, since the urethral support device (10a) indicated by solid lines is shorter in width than the urethral support device (10b) indicated by dotted lines, the urethral support device indicated by solid lines can be positioned further forward (in the upper direction of the drawing) between the two pubic bones (71) arranged in a triangular pyramid shape in the drawing, and thus the distance L1 between the urethral support portion (30a) of the urethral support device indicated by solid lines and the urethra is shorter than the distance L2 between the urethral support portion (30b) of the urethral support device indicated by dotted lines and the urethra, so that urethral closure can be achieved by rapid urethral bending due to close arrangement.

Of course, if the urethral support part of the urethral support device is provided in a straight or forwardly protruding form, it can be brought closer to the urethra regardless of the angle of arrangement of the fixed body part.

However, in order to prevent twisting due to internal tissue pressure, the urethral support device must be positioned close to the anterior wall, i.e., the pubic symphysis. However, if the urethral support part is formed in a straight line, the urethral support part may compress the urethra anteriorly even in normal times when the urethral support device is positioned anteriorly, which may cause urethral obstruction, and may even interfere with normal urination.

In addition, it is desirable to form a urethral support portion that wraps the entire urethra in a posteriorly protruding shape rather than a straight or protruding shape to increase the contact area with the urethra and achieve efficient urethral bending.

As shown in Fig. 2a, the urethral support device (10) is preferably provided with the fixed body part (20) positioned forward and the urethral support part (30) and the body connection part (40) positioned rearward in a U-shape so as not to compress the urethra (81) positioned rearward of the fixed body part in normal times, while supporting the lower part of the urethra that descends rearward when abdominal pressure is generated, thereby achieving urethral closure by urethral bending.

In addition, as shown in Fig. 2a, the urethral support device of the present invention is installed in two pubic bones with the fixed body portion positioned at an angle of 45 degrees or more and less than 180 degrees, so that support can be provided in both lateral directions, thereby stably fixing the position against lateral pressure.

Figure 2b is a schematic drawing of section A-A of Figure 2a, where the cross-sectional area is the pubic symphysis connecting the pubic bones on both sides, and the urethra is drawn to pass through the space between the pubic bones adjacent to the pubic symphysis.

Here, the urethra support device (10) of the present invention is positioned so that the fixed body part (20) is placed at the lower end of the pubic symphysis (72) or the pubic bone (71) on both sides close to the pubic symphysis, and the urethra support part (30) and the body connection part (40) are positioned to surround the rear (right side of the drawing) of the urethra (81).

Accordingly, the left and right pubic bones (71) are installed so that the fixed body part (20) of the urethral support device is in line or surface contact with the lower back of the pubic bone in an inclined shape so that the upper width is wider than the lower width, and by having a surface that extends upward, it can stably support the abdominal pressure generated in the upper and lower directions and provide fixing force.

In addition, since the fixed body part (20) is close to the front wall part of the pubic bone (71) which has an “L” shaped vertical cross section, it can minimize deformation by receiving less pressure change of the body tissue, and thus can maintain the initial installation position as much as possible.

The urethral support device (10) of the present invention, which is equipped in this manner, is normally positioned so that the urethral support part (30) is close to the urethra (81) and does not compress the urethra. In addition, when abdominal pressure occurs, the bladder (80) moves backward and downward, and the urethra (81) connected to the bladder also moves backward and downward.

At this time, the urethra support part (30) of the urethra support device (10) supports the rear surface of the urethra (81), and the urethra (81) is bent by the urethra support part (30), thereby achieving urethral closure.

In particular, if the urethral support part (30) is formed to extend upward, the part supporting the urethra (81) can be brought closer to the bladder (80), so that rapid urethral closure can be achieved when abdominal pressure occurs.

The urethra support device (10) of the present invention can be formed in various forms in which the urethra support portion (30) and the body connection portion (40) extend rearward.

Figure 3 is a side view of a urethral support device according to the present invention, showing various forms in which the urethral support part (30) and the body connection part (40) are connected through the upper and lower parts of the left and right fixed body parts (20).

As mentioned above, the upper and lower parts of the fixed body part (20) are extended backwards to form the urethra support part (30) and the body connection part (40). However, the urethra support part (30) and the body connection part (40) may be formed in a parallel manner, such as extending horizontally backwards (a in FIG. 3), extending upwards (b in FIG. 3), or extending downwards (c in FIG. 3), in a form in which they are extended backwards.

In addition, one or more of the urethral support portion (30) and the body connecting portion (40) may be extended in different directions so that the two extension portions intersect each other vertically (d in FIG. 3), are extended so that they spread apart vertically (e in FIG. 3), or are extended in a tapered manner to converge at one point or center (f in FIG. 3), thereby preventing distortion of the left and right fixed body portions (20) and fixing the position.

Here, the fixed body part (20) is illustrated as an arch shape, but the upper urethral support part (30) may be positioned forward to provide a diagonal straight shape, and the fixed body part may also be provided in a curved shape corresponding to the back of the pubic bone.

In addition, the above urethral support part (30) and the body connection part (40) can be connected through points spaced apart from the upper and lower ends of the left and right fixed body parts (20).

FIG. 4 is a side view of a urethral support device according to another embodiment of the present invention, showing various forms in which the urethral support part (30) and the body connection part (40) are connected by extending rearwardly through a point spaced a certain distance from the upper and lower ends of the left and right fixed body parts (20) toward the middle point.

As mentioned above, the urethra support part (30) and the body connection part (40) are formed by extending backwards through a point spaced a certain distance apart from the upper and lower ends of the fixed body part (20) in the direction of the middle point. However, the urethra support part (30) and the body connection part (40) can be formed in a parallel manner, such as extending backwards horizontally (a in FIG. 4), extending upwards (b in FIG. 4), or extending downwards (c in FIG. 4), in the form of being extended backwards.

In addition, one or more of the urethral support portion (30) and the body connecting portion (40) may be formed in various forms, such as extending in different directions so that the two extension portions intersect each other vertically (d in FIG. 4), extending so that they are spread apart vertically (e in FIG. 4), or extending in a tapered manner so that they converge at one point or center (f in FIG. 4).

In another form, as shown in FIG. 5, the urethra support part (30) and the body connection part (40) are respectively extended and connected through a single point from the rear side of the left and right fixed body parts (20), with the urethra support part (30) being extended upward and the body connection part (40) being extended downward and arranged to be spread out vertically can be provided as a structure (a of FIG. 5).

In this way, if connected through the same point, the effect of preventing twisting of the fixed body part is somewhat reduced, but connecting the left and right fixed body parts through two lines can improve the support force more than connecting them using only one urethral support part, and can also improve the fixing force at the location where the urethral support device is installed.

In addition, as shown in FIG. 5 (b of FIG. 5), the urethra support device (10) of the present invention can support the left and right fixed body parts (20) by connecting them to each other using one urethra support part (30) and a plurality of body connection parts (40).

By forming the above body connecting parts (40) in multiple pieces, the left and right fixed body parts are connected by multiple contact points, thereby minimizing twisting, and by forming a shorter body connecting part, the basic closing pressure of the urethra can also be increased.

In addition to independently connecting multiple body connecting parts as shown, they may be provided in a network structure in which they intersect each other.

In addition, the urethra support part and the body connection part may be connected as one in whole or in part, and the connected part may be formed as a surface to support the rear of the urethra. At this time, the surface may be provided as a wide surface connecting the upper urethra support part and the lower body connection part, and may be formed as a wide mesh to provide twist prevention and urethra support functions.

10,10a: Urethral support device
20,20a : Fixed body part
21: Front 22: Auxiliary frame
23: Through hole 25: Side extension part
26: Vertical connection part
30,30a: Urethral support
31 : Acceptance Home
40,40a : Body connection part
70 : Pelvic bone
71 : Pubic bone 72 ; Pubic symphysis
80 : Bladder
81 : Urethra
a : cabinet

Claims (11)

In a urethral support device for urinary incontinence treatment, which is inserted into the human body and supports the urethra as it descends under abdominal pressure to close the urethra,
A fixed body part that is placed at a certain distance on both sides of the urethra and is placed on the back of the pubic bones on both sides forming the pubic symphysis;
A urethra support section that connects the upper portions of the spaced left and right fixed body sections to support the rear of the urethra positioned inside, and supports the urethra that sags posteriorly when abdominal pressure is applied, thereby causing urethral closure by bending the urethra;
It consists of a body connecting part that supports the rear of the urethra positioned inside the spaced left and right fixed body parts, connects the left and right fixed body parts at the lower part of the urethra support part to prevent twisting of the left and right fixed body parts and helps to settle on the rear of the pubic bone;
The above fixed body part is a member formed long in the vertical direction, protrudes forward more than the urethral support part and the body connection part, and the lower part is secured to the back of the pubic bone to provide fixing force in the left-right and up-down directions. It is a urethral support device for the treatment of urinary incontinence that is inserted into the body. delete In the first paragraph,
The above fixed body part,
To protrude forward and be stably anchored to the back of the pubic bone, An implantable urethral support device for treating urinary incontinence, characterized in that the auxiliary frame is connected integrally with an expanded surface wider than the urethral support portion and the body connection portion or a hole is formed on the inside to vertically connect the expanded surface. In the third paragraph,
An implantable urethral support device for treating urinary incontinence, characterized in that the extended surfaces of the two fixed body parts on both sides are arranged to form an angle of less than 45 degrees to 180 degrees. In the first paragraph,
The above fixed body part,
An implantable urethral support device for treating urinary incontinence, characterized in that it extends laterally from a urethral support portion and a body connection portion, and then is vertically connected at the extended portion. In paragraph 5,
An implantable urethral support device for treating urinary incontinence, characterized in that the surfaces formed by the extended portions on both sides are arranged to form an angle of less than 45 degrees to less than 180 degrees. In the first paragraph,
A urethral support device for treating urinary incontinence, characterized in that the above body connecting part is formed by one or more. In the first paragraph,
A urethral support device for treating urinary incontinence, characterized in that the urethral support part and the body connection part are connected as one in whole or in part, and the connected part is formed as a surface to support the rear of the urethra. In the first paragraph,
The above urethral support part is formed by connecting backwards through the upper ends of the left and right fixed body parts, and the body connection part is formed by connecting backwards through the lower ends of the left and right fixed body parts.
The above urethral support part and the body connection part are characterized in that they are formed in a form that is extended backwards from the fixed body part and parallel to each other to form a horizontal arrangement, an upward arrangement, or a downward arrangement, or one or more of them are extended in different directions so that the two extension parts form a cross arrangement, an expanded arrangement, or a tapered arrangement. An implantable urethral support device for the treatment of urinary incontinence. In the first paragraph,
The above urethral support part is formed by connecting backwards through an upper connection point, which is a point spaced a certain distance from the upper part of the left and right fixed body parts to the middle point, and the body connection part is formed by connecting backwards through a lower connection point, which is a point spaced a certain distance from the lower part of the left and right fixed body parts to the middle point.
The above urethral support part and the body connection part are characterized in that they are formed in a form that is extended backwards from the fixed body part and parallel to each other to form a horizontal arrangement, an upward arrangement, or a downward arrangement, or one or more of them are extended in different directions so that the two extension parts form a cross arrangement, an expanded arrangement, or a tapered arrangement. An implantable urethral support device for the treatment of urinary incontinence. In the first paragraph,
The above urethral support part and the body connection part are each connected through the same point of the left and right fixed body parts,
An implantable urethral support device for treating urinary incontinence, characterized in that the urethral support part is connected so as to be positioned upward, and the fixed body part is connected so as to be positioned downward, and the urethral support part is positioned so as to be positioned so as to spread up and down at one point.

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