Partial Urethral Cuff for Stress Incontinence
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Solution Overview
Problem
Current surgical methods for managing stress urinary incontinence, such as urethral slings and artificial urinary sphincters, often result in complications like bladder puncture, nerve damage, and limited adjustability, and require complex procedures that may not allow natural urination.
Innovation Solution
A surgically implanted partial cuff that only partially surrounds the urethra with a flexible mesh base and an adjustable expandable component, allowing for precise adjustment of urethral resistance without occluding the urethra, enabling natural voiding and minimizing complications.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a full artificial urinary sphincter band completely surrounds the urethra to occlude it continuously, then incontinence is controlled, but the patient cannot urinate without actively pumping fluid out of the band
Solution Approach 1:
The cuff is designed to surround only a portion (approximately 180 degrees) of the urethra rather than completely encircling it. This segmentation allows the occlusion function to be performed on the cuffed portion while leaving the uncuffed portion open for natural urine passage, eliminating the need for active pumping mechanisms.
Solution Approach 2:
Instead of applying complete occlusion around the entire urethra, the invention applies partial occlusion only to the portion of the urethra that requires support. This partial action is sufficient to control incontinence while maintaining natural urination capability through the uncuffed portion.
2Adaptability or versatility
If long rods are used to pass blindly from one anatomical site to another for sling implantation, then the sling can be anchored in anatomical locations, but bladder puncture and blood vessel injury occur
Solution Approach 1:
The invention extracts the anchoring function from distant anatomical structures (pubic symphysis, abdominal muscles) and relocates it to the urethra itself. The cuff is anchored directly to the urethral wall, eliminating the need for long rods that pass blindly through the body and cause injuries to the bladder and blood vessels.
Solution Approach 2:
The cuff acts as an intermediary device that is directly attached to the urethra, providing the anchoring function locally without requiring transmission through long rods. This intermediary approach allows precise placement and anchoring while avoiding the harmful effects of blind passage through anatomical structures.
3Reliability
If the sling is anchored in anatomical structures other than the urethra, then the sling can provide support, but injuries to bladder, blood vessels, nerves and muscles occur
Solution Approach 1:
The anchoring function is extracted from external anatomical structures (bladder, blood vessels, nerves, muscles) and relocated to the urethra itself. The cuff is anchored directly to the urethral wall, providing the necessary support function while eliminating injuries to surrounding anatomical structures.
Solution Approach 2:
The support function is localized to the urethra where it is needed, rather than being distributed through anchoring in multiple distant anatomical structures. The cuff provides localized support to the urethral wall, maintaining the support function while avoiding harm to other tissues.
4Ease of manufacture
If a precise adjustment of sling tension is not possible, then the surgical procedure is simpler, but lower than expected efficacy and urethral erosions occur
Solution Approach 1:
The cuff incorporates an expandable component that can be adjusted after implantation to achieve the desired tension. This dynamic adjustment capability allows the surgeon to optimize the fit and tension post-operatively, improving efficacy and preventing complications like urethral erosion while maintaining procedural simplicity.
Solution Approach 2:
The cuff is implanted in a relaxed state and then expanded to the desired tension level after the surgical site has healed. This preliminary implantation followed by later expansion allows for safe initial placement and subsequent optimization of tension without rushing the adjustment process, thereby improving both safety and efficacy.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The partial cuff effectively increases urethral resistance to prevent incontinence during stress situations while allowing natural urination, reducing surgical complexity and avoiding adverse events associated with traditional methods.
Implementation Method 1
the expansion of the component forces the urethral wall inward... resulting in narrowing of the urethral lumen, leading to an increased coaptation and resistance to urine flow
Implementation Method 2
a mesh base member... allowing for tissue ingrowth to secure attachment of the cuff to the wall of the tubular organ
Data Source
Figure 1a~2
Figure 3a~4
Figure 5a~5b
AI summary
To increase the resistance to liquid and substance flow through a lumen of a tubular organ, a cuff comprising a flexible, mesh base member is appended to an exterior wall of the tubular organ such that it only partially surrounds the tubular organ. Ultimately, tissue ingrowth through the mesh base member integrates the cuff into the wall of the tubular organ. When the cuff is applied to the urethra of an incontinent patient, the increased resistance to flow renders the patient continent while still allowing normal voiding. The base member may also support an optional expandable component, e.g., a balloon-like element that can be selectively inflated and/or deflated to restrict the lumen of the tubular organ by a desired degree.