Implantable sling having bladder support
Surgical implants operative to simultaneously function as a pubovaginal sling for the treatment of incontinence and as a support member to effectuate cystocele repair. The implant comprises a first sling portion operative to be positioned beneath the urethra, per conventional pubovaginal sling surgery. The implant further includes a second bladder support portion extending from the sling support portion that is oriented to extend beneath and be surgically attached to a portion of the bladder to thus enable the same to be supported to a degree necessary to effectuate cystocele repair. The implant may be fabricated from a unitary piece of harvested tissue, synthetic material or combinations thereof. Preferably, the sling portion of the implant is fabricated from a synthetic material whereas the bladder support portion of the implant comprises a segment of harvested tissue sewn to the sling portion.
1. A prefabricated implant for concomitantly treating incontinence and effectuating cystocele repair in a female patient in need thereof comprising:
a. a sling portion fabricated from a first material selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
b. a bladder support portion fabricated from a second material selected for a property particularly well suited for support of a bladder, said bladder support portion being operatively positionable to substantially prevent said bladder from pushing against the vagina of said patient; and,
c. said bladder support portion connected to and extending from said sling portion; and,
d. said property particularly well suited for support of a urethra being absent in said second material and said property particularly well suited for support of a bladder being absent in said first material.
2. The implant of claim 1 , wherein said sling portion comprises an elongate segment defining opposed ends.
3. The implant of claim 2 , wherein said sling portion has a generally rectangular shape.
4. The implant of claim 1 , wherein said sling portion and said bladder support portion are integrally formed with one another.
5. The implant of claim 4 , wherein said first material is a synthetic.
6. The implant of claim 1 , wherein said sling portion defines a continuous peripheral edge and said bladder support portion defines a continuous peripheral edge, said sling portion and said bladder support portion being interconnected to one another by a segment of stitching whereby a portion of said peripheral edge of said sling portion is stitched to a portion of said peripheral edge of said bladder support portion.
7. The implant of claim 6 , wherein said second material is harvested tissue and said first material is synthetic material.
8. The implant of claim 6 , wherein said sling portion and said bladder support portion cooperate to define a generally T-shape.
9. A method for concomitantly treating a female patient afflicted with urinary incontinence and effectuating cystocele repair via a single surgical procedure comprising the steps:
a. providing a pre-fabricated implant comprising:
i. a sling portion selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
ii. a bladder support portion selected for a property particularly well suited for support of a bladder, said bladder support portion formed from harvested tissue and connected to and extending from said sling portion, said bladder support portion being operatively positionable against said bladder of said patient to substantially prevent said bladder from pushing against the vagina of said patient, said property particularly well suited for support of a urethra being absent in said bladder support portion and said property particularly well suited for support of a bladder being absent in said sling portion;
b. forming an incision within the vagina of said patient; and
c. transvaginally implanting said implant provided in step (a) through said incision made in step (b) such that said sling portion of said implant is operatively positioned beneath the urethra of said patient and said bladder support portion of said implant is operatively positioned to substantially prevent said bladder from pushing against the vagina.
10. A method for concomitantly treating a female patient afflicted with urinary incontinence and effectuating cystocele repair via a single surgical procedure comprising the steps:
a. providing a pre-fabricated implant comprising:
i. a sling portion selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
ii. a bladder support portion selected for a property particularly well suited for support of a bladder, said bladder support portion connected to and extending from said sling portion, said bladder support portion being operatively positionable to substantially prevent said bladder from pushing against the vagina of said patient, said property particularly well suited for support of a urethra being absent in said bladder support portion and said property particularly well suited for support of a bladder being absent in said sling portion;
b. forming an incision within the abdomen of said patient; and
c. implanting said implant provided in step (a) through said incision made in step (b) such that said sling portion of said implant is operatively positioned beneath the urethra of said patient and said bladder support portion of said implant is operatively positioned to substantially prevent said bladder from pushing against the vagina.
11. A method for concomitantly treating a female patient afflicted with urinary incontinence and effectuating cystocele repair via a single surgical procedure comprising the steps:
a. providing a prefabricated implant comprising:
i. a sling portion selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
ii. a bladder support portion selected for a property particularly well suited for support of a bladder, said bladder support portion connected to and extending from said sling portion, said bladder support portion being operatively positionable to substantially prevent said bladder from pushing against the vagina of said patient, said property particularly well suited for support of a urethra being absent in said bladder support portion and said property particularly well suited for support of a bladder being absent in said sling portion;
b. forming at least one incision in said patient; and
c. implanting said implant provided in step (a) and into the obturator foramen via said at least one incision made in step (b) such that said sling portion of said implant is operatively positioned beneath the urethra of said patient and said bladder support portion of said implant is operatively positioned to substantially prevent said bladder from pushing against the vagina.
12. An implant for concomitantly treating incontinence and effectuating rectocele repair in a patient in need thereof comprising:
a. a sling portion fabricated from a first material selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
b. a rectum support portion fabricated from a second material selected for a property particularly well suited for support of a rectum said rectum support portion being operatively positionable to substantially eliminate prolapse of the rectum; and,
c. said rectum support portion connected to and extending from said sling portion; and,
d. said property particularly well suited for support of a urethra being absent in said second material and said property particularly well suited for support of a rectum being absent in said first material.
13. An implant for concomitantly treating incontinence and effectuating enterocele repair in a patient in need thereof comprising:
a. a sling portion fabricated from a first material selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
b. an intestinal support portion fabricated from a second material selected for a property particularly well suited for support of an intestine, said intestinal support portion being operatively positionable to effectuate enterocele repair; and,
c. said intestinal support portion connected to and extending from said sling portion; and,
d. said property particularly well suited for support of a urethra being absent in said second material and said property particularly well suited for support of an intestine being absent in said first material.
14. The implant of claim 6 , wherein said second material is harvested tissue.
15. The implant of claim 6 , wherein said first material is synthetic.
16. A method for concomitantly treating a female patient afflicted with urinary incontinence and effectuating rectocele repair via a single surgical procedure comprising the steps:
a. providing a pre-fabricated implant comprising:
i. a sling portion formed from a first material selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
ii. a rectum support portion formed from a second material selected for a property particularly well suited for support of a rectum and connected to and extending from said sling portion, said rectum support portion being operatively positionable to substantially prevent said rectum from pushing against the vagina of said patient;
iii. said rectum support portion connected to and extending from said sling portion; and,
iv. said property particularly well suited for support of a urethra being absent in said second material and said property particularly well suited for support of a rectum being absent in said first material
b. forming an incision within said patient; and
c. implanting said implant provided in step (a) through said incision made in step (b) such that said sling portion of said implant is operatively positioned beneath the urethra of said patient and said rectum support portion of said implant is operatively positioned to substantially prevent said rectum from pushing against the vagina.
17. The method of claim 16 , wherein in step (b), said incision is made within the vagina of said patient.
18. The method of claim 16 , wherein in step (a), said implant is fabricated from a material selected from the group consisting of a synthetic material and a harvested tissue.
19. The method of claim 18 wherein in step (a), said sling portion of said implant is fabricated from a synthetic material and said rectum support portion is fabricated from harvested tissue.
20. A method for concomitantly treating a female patient afflicted with urinary incontinence and effectuating enterocele repair via a single surgical procedure comprising the steps:
a. providing a pre-fabricated implant comprising:
i. a sling portion formed from a first material selected for a property particularly well suited for support of a urethra, said sling portion being operatively positionable beneath the urethra of said patient; and
ii. an intestinal support portion formed from a second material selected for a property particularly well suited for support of an intestine, said intestinal support portion being operatively positionable to substantially prevent said intestine from pushing against the vagina of said patient;
iii. said intestinal support portion connected to and extending from said sling portion; and,
iv. said property particularly well suited for support of a urethra being absent in said second material and said property particularly well suited for support of an intestine being absent in said first material
b. forming an incision within said patient; and
c. implanting said implant provided in step (a) through said incision made in step (b) such that said sling portion of said implant is operatively positioned beneath the urethra of said patient and said intestinal support portion of said implant is operatively positioned to substantially prevent said intestine from pushing against the vagina.
21. The method of claim 20 , wherein in step (b), said incision is made within the vagina of said patient.
22. The method of claim 20 , wherein in step (a), said implant is fabricated from a material selected from the group consisting of a synthetic material and a harvested tissue.
23. The method of claim 22 , wherein in step (a), said sling portion of said implant is fabricated from a synthetic material and said intestinal support portion is fabricated from harvested tissue.
24. The prefabricated implant according to claim 1 , wherein said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a bladder is optimal biocompatibility.
25. The method of claim 9 , wherein in step (a), said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a bladder is optimal biocompatibility.
26. The method of claim 10 , wherein in step (a), said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a bladder is optimal biocompatibility.
27. The method of claim 11 , wherein in step (a), said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a bladder is optimal biocompatibility.
28. The implant according to claim 12 , wherein said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a rectum is optimal biocompatibility.
29. The implant according to claim 13 , wherein said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of an intestine is optimal biocompatibility.
30. The method of claim 16 , wherein in step (a), said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of a rectum is optimal biocompatibility.
31. The method of claim 20 , wherein in step (a), said property particularly well suited for support of a urethra is exceptional durability and said property particularly well suited for support of an intestine is optimal biocompatibility.