Apparatus for treating stress and urge incontinence
View Patent ↗Apparatus is provided, including an implantable mechanical support, shaped to support a portion of a urethra of a patient. One or more electrodes are coupled to the mechanical support, so as to contact tissue of the patient when the mechanical support is implanted in the patient. A control unit drives the electrodes to apply a current to the tissue. A method for treating a patient is also provided, including implanting a mechanical support in a position that supports a urethra of a patient. In response to increased pelvic pressure of the patient, a substance stored in a portion of the mechanical support that is not under the urethra is moved to a portion of the mechanical support that is under the urethra. Other embodiments are also described.
1. A method, comprising:
providing an implantable member comprising mesh and at least one electrode;
making at least one incision in a patient;
implanting the member in contact with pelvic tissue of the patient comprising passing the implantable member through the at least one incision;
driving a current through the at least one electrode into the pelvic tissue of the patient; and
implanting a control unit in the patient comprising passing the control unit through the at least one incision, wherein driving a current through the at least one electrode comprises driving a current through the at least one electrode using the control unit.
2. The method according to claim 1 , wherein the mesh forms a sling.
3. The method according to claim 1 , comprising inducing relaxation of a pelvic muscle of the patient responsive to driving a current.
4. The method according to claim 1 , comprising treating a condition of the patient responsive to driving a current through the at least one electrode, wherein the condition of the patient is selected from the group consisting of: urge incontinence, bladder dysfunction, mixed incontinence, overactive bladder, interstitial cystitis, and fecal incontinence.
5. The method according to claim 1 , comprising treating incontinence of the patient responsive to driving a current through the at least one electrode.
6. The method of claim 5 , wherein treating incontinence of the patient responsive to driving a current through the at least one electrode comprises contracting the urinary sphincter of the patient.
7. The method according to claim 1 , comprising inducing relaxation of a bladder muscle of the patient without contracting a pelvic muscle of the patient responsive to driving a current through the at least one electrode.
8. The method according to claim 1 , comprising treating incontinence responsive to driving a current.
9. The method according to claim 8 , comprising generating a signal indicative of imminent incontinence of the patient.
10. The method of claim 1 , further comprising treating urge incontinence of the patient responsive to driving a current.
11. The method of claim 1 , wherein the at least one electrode is coupled to the mesh.
12. The method of claim 1 , further comprising mechanically supporting a pelvic structure of the patient using the mesh.
13. The method according to claim 12 , comprising treating incontinence responsive to mechanically supporting a pelvic structure of the patient using the mesh.
14. The method according to claim 12 , comprising treating cystocele responsive to mechanically supporting a pelvic structure of the patient using the mesh.
15. The method according to claim 12 , comprising treating pelvic organ prolapse responsive to mechanically supporting a pelvic structure of the patient using the mesh.
16. The method according to claim 12 , wherein mechanically supporting a pelvic structure of the patient comprises accessing the pelvic structure via an approach selected from the group consisting of: a suprapubic approach, a transvaginal approach, a retropubic approach, and a transobturator approach.
17. The method of claim 12 , wherein mechanically supporting comprises anchoring the member to structure of the patient other than the pelvic structure.
18. The method according to claim 12 , wherein:
mechanically supporting a pelvic structure of the patient comprises mechanically supporting a portion of the urethra of the patient with the mesh;
the at least one electrode comprises a plurality of electrodes; and
driving a current comprises driving the current from the plurality of electrodes which are aligned around less than 180 degrees of the urethra.
19. The method according to claim 18 , comprising:
at a pre-implantation time prior to a first time of mechanically supporting the portion of the urethra, identifying the patient as not suffering from urge incontinence; and at a post-implantation time subsequent to the first time of mechanically supporting the portion of the urethra, identifying the patient as suffering from urge incontinence, wherein driving the current comprises:
not driving the current on each of any 30 consecutive days prior to the post-implantation time; and
driving the current on each of at least 30 consecutive days following the post-implantation time.
20. The method according to claim 18 , wherein driving a current comprises starting to drive a current on each of at least 30 consecutive days at a time greater than 60 days from a first time of mechanically supporting the portion of the urethra.
21. The method according to claim 20 , comprising treating at least one condition responsive to driving a current, wherein the at least one condition including a condition that is not stress incontinence.
22. A method, comprising:
providing an implantable member comprising mesh and a plurality of electrodes;
making at least one incision in a patient;
implanting the member in contact with pelvic tissue of the patient comprising passing the implantable member through the at least one incision;
mechanically supporting a pelvic structure of the patient using the mesh comprising mechanically supporting a portion of the urethra of the patient with the mesh, wherein the electrodes are aligned around less than 180 degrees of the urethra; and
driving a current through at least one of the plurality of electrodes into the pelvic tissue of the patient, comprising starting to drive a current on each of at least 30 consecutive days at a time greater than 60 days from a first time of mechanically supporting the portion of the urethra.
23. The method according to claim 22 , comprising treating at least one condition responsive to driving a current, wherein the at least one condition including a condition that is not stress incontinence.
24. The method according to claim 22 , comprising treating incontinence responsive to mechanically supporting a pelvic structure of the patient using the mesh.
25. The method according to claim 22 , comprising treating cystocele responsive to mechanically supporting a pelvic structure of the patient using the mesh.
26. The method according to claim 22 , comprising treating pelvic organ prolapse responsive to mechanically supporting a pelvic structure of the patient using the mesh.
27. The method according to claim 22 , wherein the mesh forms a sling.
28. The method according to claim 22 , wherein mechanically supporting a pelvic structure of the patient comprises accessing the pelvic structure via an approach selected from the group consisting of: a suprapubic approach, a transvaginal approach, a retropubic approach, and a transobturator approach.
29. The method according to claim 22 , comprising inducing relaxation of a pelvic muscle of the patient responsive to driving a current.
30. The method according to claim 22 , comprising treating a condition of the patient responsive to driving a current, wherein the condition of the patient is selected from the group consisting of: urge incontinence, bladder dysfunction, mixed incontinence, overactive bladder, interstitial cystitis, and fecal incontinence.
31. The method according to claim 22 , comprising treating incontinence of the patient responsive to driving a current through the at least one electrode.
32. The method according to claim 22 , comprising inducing relaxation of a bladder muscle of the patient without contracting a pelvic muscle of the patient responsive to driving a current.
33. The method according to claim 22 , comprising implanting a control unit in the patient comprising passing the control unit through the at least one incision, wherein driving a current through at least one of the plurality of electrode comprises driving a current through at least one of the plurality of electrodes using the control unit.
34. A method, comprising:
providing an implantable member comprising mesh and a plurality of electrodes;
making at least one incision in a patient;
implanting the member in contact with pelvic tissue of the patient comprising passing the implantable member through the at least one incision;
mechanically supporting a pelvic structure of the patient using the mesh comprising mechanically supporting a portion of the urethra of the patient with the mesh, wherein the electrodes are aligned around less than 180 degrees of the urethra; and
driving a current through at least one of the plurality of electrodes into the pelvic tissue of the patient;
wherein:
at a pre-implantation time prior to a first time of mechanically supporting the portion of the urethra, identifying the patient as not suffering from urge incontinence; and
at a post-implantation time subsequent to the first time of mechanically supporting the portion of the urethra, identifying the patient as suffering from urge incontinence, wherein driving the current comprises:
not driving the current on each of any 30 consecutive days prior to the post-implantation time; and
driving the current on each of at least 30 consecutive days following the post-implantation time.
35. The method according to claim 34 , comprising treating at least one condition responsive to driving a current, wherein the at least one condition including a condition that is not stress incontinence.
36. The method according to claim 34 , comprising treating incontinence responsive to mechanically supporting a pelvic structure of the patient using the mesh.
37. The method according to claim 34 , comprising treating cystocele responsive to mechanically supporting a pelvic structure of the patient using the mesh.
38. The method according to claim 34 , comprising treating pelvic organ prolapse responsive to mechanically supporting a pelvic structure of the patient using the mesh.
39. The method according to claim 34 , wherein the mesh forms a sling.
40. The method according to claim 34 , wherein mechanically supporting a pelvic structure of the patient comprises accessing the pelvic structure via an approach selected from the group consisting of: a suprapubic approach, a transvaginal approach, a retropubic approach, and a transobturator approach.
41. The method according to claim 34 , comprising inducing relaxation of a pelvic muscle of the patient responsive to driving a current.
42. The method according to claim 34 , comprising treating a condition of the patient responsive to driving a current, wherein the condition of the patient is selected from the group consisting of: urge incontinence, bladder dysfunction, mixed incontinence, overactive bladder, interstitial cystitis, and fecal incontinence.
43. The method according to claim 34 , comprising treating incontinence of the patient responsive to driving a current through the at least one electrode.
44. The method according to claim 34 , comprising inducing relaxation of a bladder muscle of the patient without contracting a pelvic muscle of the patient responsive to driving a current.
45. The method according to claim 34 , comprising implanting a control unit in the patient comprising passing the control unit through the at least one incision, wherein driving a current through at least one of the plurality of electrode comprises driving a current through at least one of the plurality of electrodes using the control unit.