Treatment of the reproductive tract with pulsed electric fields
Devices, systems and methods are provided for treating conditions of the reproductive tract. A number of conditions can afflict the lining and cell layers deeper within the anatomical structures. For example, cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is a condition involving abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer in situ (CIS). Other conditions include human papillomavirus (HPV)-related cervical disease, various endometrial diseases, acute and chronic cervicitis, and various infections (e.g. trichomoniasis) to name a few. In some embodiments, treatments eliminate diseased, damaged, abnormal or otherwise undesired cells leaving the tissue framework intact. This allows the tissue to regenerate in a normal fashion, avoiding the formation of scar tissue. When the tissue framework is left intact, the framework structure repopulates with healthy cells, regenerating the normal tissue without altering the structural properties.
1 . A system for treating an area of tissue suffering from dysplasia or cancer within a reproductive system of a patient comprising:
a catheter comprising an elongate shaft and an energy delivery body disposed near a distal end of the elongate shaft, wherein the elongate shaft is configured to be advanced into a luminal structure of the reproductive system so as to position the energy delivery body near or against the area of tissue suffering from dysplasia or cancer within the reproductive system; and
a generator couplable with the catheter, wherein the generator includes at least one energy delivery algorithm configured to be capable of providing an electric signal of energy at a depth of 2 mm and less into a wall of the luminal structure, wherein the energy is deliverable by the energy delivery body so as to treat the area of tissue suffering from dysplasia or cancer at a depth of up to 2 mm, wherein the energy comprises non-thermal energy and treating the area of tissue suffering from dysplasia or cancer comprises destroying at least a portion of cells suffering from dysplasia or cancer within the area of tissue while maintaining its collagen structure.
2 . A system as in claim 1 , wherein the luminal structure comprises a cervix, a vagina, a uterus, an endocervical canal or a fallopian tube.
3 . A system as in claim 2 , wherein the energy delivery body comprises a flexible expandable member configured to be pressable against the luminal structure so as to conform to contours of the luminal structure.
4 . A system as in claim 3 , wherein the flexible expandable member includes one or more flexible electrodes.
5 . A system as in claim 1 , wherein the electric signal comprises a series of biphasic pulses delivered in packets to provide the non-thermal energy.
6 . A system as in claim 5 , wherein each of the biphasic pulses has a voltage between approximately 500-4000 V.
7 . A system as in claim 5 , wherein the electric signal has a frequency in the range of approximately 100-1000 kHz.
8 . A system as in claim 1 , wherein the energy delivery body has a shape configured to mate with contours of a cervix of the reproductive system of the patient.
9 . A system as in claim 1 , wherein the catheter further comprises a stabilizing element configured to be advanced into a uterus of the patient to stabilize the catheter while the energy delivery body resides in a vagina of the patient so as to deliver energy to a cervix.
10 . A system as in claim 1 , wherein the catheter further comprises a second energy delivery body, wherein the second energy delivery body is configured to be advanced into a uterus of the patient so as to treat an area of tissue within the uterus while the energy delivery body resides in a vagina of the patient so as to treat an area of tissue within the vagina.
11 . A system as in claim 10 , further comprising a third energy delivery body configured to be advanced into an endocervical canal of the patient.
12 . A system as in claim 1 , wherein the energy delivery body comprises a probe configured to penetrate a wall of a luminal structure within the reproductive system and deliver the energy to the area of tissue.
13 . A method of treating an area of tissue having cells suffering from dysplasia or cancer within a reproductive system of a patient comprising:
inserting a distal end of a catheter having an energy delivery body into a luminal structure of the reproductive system;
positioning the energy delivery body near the area of tissue having the cells suffering from dysplasia or cancer; and
providing energy to the catheter with the use of a generator having an energy delivery algorithm configured to be capable of delivering energy at a depth of 2 mm into a wall of the luminal structure so that the energy delivery body delivers the energy to the area of tissue so as to treat the area of tissue to a depth of up to but not beyond 2 mm into a wall of the luminal structure, and wherein the energy comprises non-thermal energy that leads to destruction of at least a portion of the cells suffering from dysplasia or cancer in the area of tissue while maintaining a collagen structure within the area of tissue.
14 . A method as in claim 13 , wherein providing energy to the catheter comprises providing energy to but not beyond an epithelial layer of the luminal structure within the reproductive tract.
15 . A method as in claim 13 , wherein the luminal structure comprises a cervix, vagina, uterus, endocervical canal or fallopian tube.
16 . A method as in claim 13 , wherein providing energy to the catheter comprises providing energy to the catheter so that the energy delivery body delivers energy to the area of tissue to a depth of up to 3 cm from an exterior of a wall of the luminal structure.
17 . A method as in claim 13 , further comprising positioning a return electrode at a distance from the energy delivery body so that the energy delivery body functions in a monopolar fashion.
18 . A method as in claim 13 , further comprising delivering a liquid to the area of tissue, wherein the liquid comprises a conductive solution.
19 . A method as in claim 13 , further comprising delivering a liquid to the area of tissue, wherein the liquid comprises adjuvant material and wherein the energy encourages uptake of the adjuvant material.
20 . A method as in claim 19 , wherein the adjuvant material comprises a molecule, a macromolecule, or a plasmid.