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WO2004096087A1 - Prothese de sphincter uretral masculin - Google Patents

Prothese de sphincter uretral masculin Download PDF

Info

Publication number
WO2004096087A1
WO2004096087A1 PCT/US2003/012742 US0312742W WO2004096087A1 WO 2004096087 A1 WO2004096087 A1 WO 2004096087A1 US 0312742 W US0312742 W US 0312742W WO 2004096087 A1 WO2004096087 A1 WO 2004096087A1
Authority
WO
WIPO (PCT)
Prior art keywords
urethral prosthesis
pillow
substrate
inflatable pillow
urethral
Prior art date
Application number
PCT/US2003/012742
Other languages
English (en)
Inventor
Steven W. Siegel
Kevin R. Arnal
Original Assignee
Ams Research Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ams Research Corporation filed Critical Ams Research Corporation
Priority to PCT/US2003/012742 priority Critical patent/WO2004096087A1/fr
Priority to AU2003228679A priority patent/AU2003228679A1/en
Publication of WO2004096087A1 publication Critical patent/WO2004096087A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0022—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse placed deep in the body opening
    • A61F2/0027—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse placed deep in the body opening inflatable

Definitions

  • AMS Sphincter 800 available from American Medical Systems, Minnetonka,
  • AMS InVance a bone-screw fixated male sling
  • U.S. Patent No. 6,502,578 and U.S. Publish Patent Application 2001/0023356, both to Raz et al. report an apparatus and method for treatment of male incontinence in which a "hammock-like" prosthesis is positioned between the descending rami of the pubic bone.
  • the prosthesis includes an inflatable balloon device positioned to provide passive compression on the bulbar urethra to prevent voiding of the bladder. The volume of the balloon may be adjusted after implantation in a patient with a
  • prosthesis including a tape having an expandable pillow adapted to be
  • the pillow may be positioned between the tape and the urethra after implantation.
  • the pillow may
  • U.S. Patent No. 3,789,828 to Schulte reports a urethral prosthesis including a capsule having a liquid filled cavity and two flexible prosthesis ties.
  • U. S. Patent No. 4,019,499 to Fitzgerald reports a compression implant for urinary incontinence including a cap with an external planar pressure face, a base with an external bearing face and a wall connecting the cap and the base.
  • the cap, base and wall form a cavity that may be filled with an adjustable
  • the device includes a chamber with a volume that may be adjusted by varying the amount of fluid in the chamber.
  • a capsule connected to the chamber via a tube may be used to increase or decrease the amount of fluid in the chamber.
  • Each end of a thread is connected to an end of the chamber, and the thread is adapted to surround an organ. By adjusting the volume of the chamber the thread lifts or lowers the organ as desired.
  • PCT Application 00/18319 reports a prosthesis including a flexible
  • the elongate member a distensible portion, a conduit and a valve.
  • the distensible portion is bonded to the elongate member and may be filled with a fluid.
  • the conduit provides fluid communication between the distensible portion and the
  • Fluid may be injected into the valve to adjust the pressure of the
  • chambers may reduce unintentional voiding of the bladder, current chambers may suffer from one or more drawbacks. For example, if the chambers are not
  • Such strain may be generally anchored to an anatomical structure in the body. Such strain may
  • the patient may be unable to void the bladder. This too would require a
  • the present invention provides a urethral prosthesis including a biocompatible implantable substrate, an inflatable pillow attached to the
  • substrate that is adapted to house an inflating agent, a pressurized reservoir in fluid communication with the inflatable pillow and a restrictor to regulate transfer of the inflating agent between the pressurized reservoir and the
  • the inflating agent Upon compression of the inflatable pillow, the inflating agent
  • the inflating agent is adapted to transfer from the pillow to the pressurized reservoir. However, upon terminating compression of the inflatable pillow, the inflating agent is
  • the prosthesis may further include a conduit to facilitate transfer of the inflating agent
  • the present invention provides a urethral prosthesis including an implantable substrate, an inflatable pillow attached to the substrate that has an inflated mode and a deflated mode, and a pressurized
  • the inflatable pillow adjusts to the deflated
  • the inflatable pillow upon terminating compression of the inflatable pillow, the inflatable pillow returns to the inflated mode after a sufficient period of time to allow voiding of a patient's bladder.
  • the present invention provides a method for treating urinary incontinence in which an embodiment of the urethral prosthesis described above is implanted in a patient.
  • the substrate is implantably secured in the patient such that the inflatable pillow is positioned to exert a force on a portion of the patient's urethra when in an inflated mode. After implantation, a pressure may be exerted on the inflatable
  • the pillow to deflate the pillow to reduce the force exerted on the portion of the patient's urethra.
  • the pressure exerted on the inflatable pillow is then reduced to allow the inflatable pillow to inflate.
  • a patient's bladder may be voided without resistance against the urethra from the inflatable pillow.
  • the inflatable pillow may
  • FIG. 1 schematically illustrates a top view of an embodiment of the
  • Fig. 2 schematically illustrates a side view of an embodiment of the present invention in an inflated mode.
  • Fig. 3 schematically illustrates a side view of the embodiment of Fig. 2 in a deflated mode.
  • Fig. 4 schematically illustrates a partial cross-section of a restrictor portion suitable for use with an embodiment of the present invention.
  • one embodiment of the urethral prosthesis 10 of the present invention includes a substrate 20, an inflatable pillow 30, a conduit 50, a restrictor 70 and a pressurized reservoir 110.
  • the substrate 20 in this embodiment may be a length of flexible, longitudinally extendable material.
  • the material may be inelastic or elastic,
  • Suitable materials for the substrate may include, but are not limited to materials such as polyester,
  • polypropylene nylon, polyethylene terephthalate, polytetrafluorethylene,
  • the substrate 20 may be configured, for example configured as a mesh, to promote tissue ingrowth.
  • the substrate 20 may be at least partially formed from a bioabsorbable material such as polylactic acid or polyglycolic acid. Suitable materials are also reported in U.S. Published Patent Application No.
  • the substrate 20 may be coated with a suitable bioactive material having a desired physiological effect.
  • suitable bioactive materials may be selectively coated on desired areas or portions of the urethral prosthesis 10 to reduce inflammation, encourage tissue in-growth
  • the substrate 20 is a polymeric mesh coated with a
  • silicone material or other suitable material, such as an elastomer, polyethylene, polypropylene, polyester or polyurethane, or a derivative or combination
  • an insertion sheath 21 may be optionally used.
  • insertion sheath 21 may be used when the substrate 20 is formed
  • the substrate 20 may also include a tensioning member, such as a tensioning suture or filament. Suitable tensioning members are disclosed
  • the substrate 20 may include suitable connectors or dilators to facilitate
  • the substrate 20 may be sized and shaped for implantation and
  • the substrate 20 may have a length between about 5 and about 25 cm, more particularly between about 10 and about 15 cm.
  • the substrate 20 may have a width of between about 0.5 and about 5 cm, more particularly between about
  • the width along the substrate 20 may vary
  • the inflatable pillow 30 may be attached to the substrate 20 in any suitable manner.
  • inflatable pillow 30 may be attached by a
  • the urethral prosthesis ,10 may have an intermediate layer (not shown) to facilitate attachment between the substrate 20
  • the inflatable pillow 30 may be attached approximately at a center point of the substrate 20.
  • a variety of shapes may be used for the inflatable pillow
  • the inflatable pillow 30 is a generally oblong
  • inflatable pillow 30 possesses a concave upper face 35, however, other embodiments may
  • inflatable pillow possess a comparatively flat or convex upper face 35 to provide maximum surface area for contact with a urethra of a patient.
  • the inflatable pillow 30 may vary widely, however, in one embodiment, the inflatable pillow 30 has a major dimension between about 1 and about 10 cm and a minor dimension between about 0.5 and about 3 cm. In another embodiment, the inflatable
  • pillow 30 may be positioned transverse with respect to the length of the
  • the inflatable pillow 30 may be formed from any suitable material
  • Suitable materials may include, but are not limited to include elastomers, silicones, polypropylenes, polyesters,
  • the inflatable pillow 30 also generally includes an opening 120 to facilitate the delivery and receipt of inflating agent from the pressurized reservoir 110.
  • the pressurized reservoir 110 is in fluid communication with the inflatable pillow 30 and is capable of pressurizing varying amounts of inflating agent such that the entire fluid system (i.e., the reservoir, inflatable pillow,
  • the pressurized reservoir 110 may be an
  • the pressurized reservoir 110 may be formed from any suitable material capable of delivering and receiving inflating agent. Suitable materials may include, but are not
  • the pressurized reservoir 110 also includes an opening 130 to facilitate the
  • Conduit 50 includes a tube 55 having a first end
  • the tube 55 may be formed from a flexible polymeric material that is resistant to kinks. Suitable materials for the tube 55 may
  • polymeric materials such as elastomers, silicones, polypropylenes, polyesters, polyurethanes and polyvinyl chlorides.
  • the tube 55 may be reinforced with a variety of suitable materials to impart t additional kink resistant properties.
  • Restrictor 70 is attached to tube 55 at an opening 135, and is attached
  • the restrictor 70 is adapted to regulate the flow of inflating agent between the inflatable pillow 30 and the pressurized reservoir 110. More particularly, the restrictor 70 allows inflating agent to flow from the inflatable pillow 30 to the pressurized reservoir 110 during compression of the inflatable pillow, but resists flow of inflating agent from the pressurized reservoir 110 to the inflatable pillow 30.
  • restrictor 70 may include a housing 140, a channel 170, a spring 80, a fluid resistor 90, a ball 100 and a valve seat 105.
  • the fluid resistor provides a narrow channel or orifice through which inflating agent may travel.
  • the ball 100, spring 80 and valve seat 105 cooperate to allow
  • inflating agent to travel from the inflatable pillow 30 to the pressurized
  • the fluid resistor 90 may include a valve or other means to provide regulated flow from the pressurized reservoir 110 to
  • the fluid resistor 90 may be combined with the ball 100, and spring 80 such that the inflating agent only travels along a single path while in the restrictor 70. More particularly, the valve seat 105 for
  • the ball 100 could have small holes to duplicate the action of the resistor 90 and thus eliminate the separate fluid resistor 90 from the restrictor 70.
  • the restrictor 70 is adjacent to the
  • pressurized reservoir 110 Other configurations are possible that place the
  • the restrictor at different proximities to the pressurized reservoir 100 and the inflatable pillow 30.
  • the restrictor may be positioned between the inflatable pillow 30 and the pressurized reservoir 110 with conduits attached to openings 131 and 135 to provide fluid communication.
  • the restrictor housing may be positioned 140 adjacent to the inflatable pillow 30 with the opening 135 of the
  • the urethral prosthesis may also include a compression region 40.
  • the compression region 40 provides a tactile locator
  • the compression region 40 may be attached to, or in communication with the inflatable pillow 30, and may
  • the inflatable pillow 30 may be located on a lower face of the inflatable pillow 30.
  • the inflatable pillow 30 may be located on a lower face of the inflatable pillow 30.
  • compression region may be attached to a portion of the substrate 20 upon which
  • the inflatable pillow 30 is attached.
  • the inflating agent used in the urethral prosthesis 10 may be any material consistent with the function of the present invention. Suitable inflating
  • agents are generally fluids, such as gasses or aqueous solutions.
  • the viscosity of the fluid may range from 0.2 centipoise to 1000 centipoise.
  • the inflatable pillow 30 is adapted to adjust between an
  • the inflatable pillow 30 is at equilibrium, sufficient amounts of the inflating
  • the inflatable pillow 30 is in the inflated mode 150.
  • the inflatable pillow 30 In the inflated mode 150, the inflatable pillow 30
  • the pressure of the inflatable pillow may be
  • inflating agent transfers from the' inflatable pillow 30, through the conduit 50 and restrictor 70 and into the pressurized reservoir 110.
  • the inflatable pillow 30 may be compressed from an inflated mode 150 as shown in Figure 2 to a deflated mode 160 as shown in
  • the term "deflated mode” refers to the inflatable pillow after sufficient compression is exerted on the inflatable pillow to transfer inflating agent to the reservoir 110 and to allow voiding of a patient's bladder.
  • the inflating agent transfers from the pressurized reservoir 110 to the inflatable pillow 30.
  • the pressurized reservoir 110 is adapted to exert sufficient pressure on the inflating fluid such that inflating agent transfers to the inflatable pillow 30 without requiring a pump system.
  • the restrictor 70 is adapted to exert sufficient pressure on the inflating fluid such that inflating agent transfers to the inflatable pillow 30 without requiring a pump system.
  • the inflatable pillow 30 does not adjust to the inflated mode 150 instantaneously, but rather, inflation occurs over a sufficient period of time to allow a patient's bladder to be voided. For example, after terminating
  • the inflatable pillow 30 may return to
  • the inflated mode 150 over a period of between about 30 seconds and about 7 minutes, more particularly between about 1 and about 4 minutes, even more
  • the urethral prosthesis 10 of the present invention may be implanted in
  • a small scrotal incision is made.
  • the urethral prosthesis 10 is then positioned in the vicinity of a patient's descending rami of the pubic bone such that the inflatable pillow 30 exerts a sufficient
  • the pressurized reservoir 110 may be implanted in the scrotum of a male patient.
  • a small transverse scrotal incision and one or two small horizontal suprapubic incisions are made.
  • a suitable guide needle similar to the needles reported in U.S. Published Patent Application Nos.
  • a second guide needle may be inserted through the optional second suprapubic incision and
  • the distal ends of the guide needles may then be secured to the optional dilators or connectors attached to the ends of substrate 20, and the urethral prosthesis 10
  • the substrate may be pulled up through the suprapubic incisions.
  • the substrate may be at least partially covered with one or more heat sealed plastic sheaths (not shown), which are removed prior to completing the procedure.
  • the urethral prosthesis 10 may then be positioned in the vicinity of a
  • the pressure exerted on the urethra may be adjusted during implantation.
  • the pressure may be
  • the pressure may be reduced by exerting downward tension in the vicinity of the inflatable pillow 30.
  • the optional tensioning members may facilitate adjustments to the urethral prosthesis 10.
  • the urethral prosthesis 10 may be secured internally within the patient
  • the urethral prosthesis 10 may be secured solely by tissue in-growth and/or tissue encapsulation. More
  • portions of the substrate 20 may be configured, for example, in a mesh configuration, to encourage tissue in-growth.
  • portions of the substrate 20 may be configured, for example, in a mesh configuration, to encourage tissue in-growth.
  • prosthesis 10 such as the inflatable pillow 30, may be configured in a manner that does not promote tissue in-growth, but may allow for tissue encapsulation.
  • prosthesis 10 may become increasingly secured within the patient by tissue in ⁇
  • portions that are in-grown with tissue secure the urethral prosthesis 10, while portions that are
  • this embodiment does not require
  • additional bone or soft tissue anchors to further secure the urethral prosthesis 10.
  • the substrate 20 may be secured to a soft tissue region, such as at the obturator internus muscles or the gracilis muscles,
  • a combination of tissue in-grown portions and suitable anchors may secure the urethral prosthesis 10.
  • the urethral prosthesis 10 may be secured to the pelvic origin of the gracilis tendon.
  • a tissue anchor may be
  • a suture may be passed medial through the tendon to secure the prosthesis in place. This technique may be used on both sides of the body in
  • tissue anchor designs and materials may be used for securing the urethral prosthesis 10 in this embodiment.
  • anchor may be formed from titanium, plastic, or stainless steel and may be
  • one or more tissue anchors may be used to secure the urethral prosthesis to the obturator internus muscles.
  • the anchor may be used to secure the urethral prosthesis to the obturator internus muscles.
  • the anchor may then be deployed through the obturator foramen and pass through the obturator externus muscle to the obturator internus muscle.
  • the anchor may then be deployed through the obturator foramen and pass through the obturator externus muscle to the obturator internus muscle.
  • the anchor may then be deployed through the obturator foramen and pass through the obturator externus muscle to the obturator internus muscle.
  • At least one anchor in each obturator internus is positioned in the anterior recess of the ischio-anal fossa, just anterior to the obturator internus muscle. At least one anchor in each obturator internus
  • the muscle in opposition may be used to secure the sling in place.
  • the urethral prosthesis 10 may be secured in this position by
  • the urethral prosthesis may be secured to the superior or inferior pubic rami with a bone screw.
  • the inflatable pillow 30 may be deflated by exerting
  • the inflatable pillow 30 then deflates, reducing the force on a portion of the patient's urethra to allow the patient's bladder to be intentionally voided. After reducing or terminating pressure on the inflatable pillow 30 (normally prior to
  • the inflatable pillow 30 returns to the inflated mode 150 over a period of time sufficient to allow voiding of the patient's bladder without allowing a subsequent unintentional voiding of the bladder.
  • the urethral prosthesis 10 is secured at least partially by tissue in-growth, it may be desirable to maintain the inflatable
  • This activation feature may be
  • the urethral prosthesis may be any suitable material.
  • the urethral prosthesis may be any suitable material.
  • the urethral prosthesis may be any suitable material.
  • the urethral prosthesis 110 may then be pressurized with inflating agent.
  • the urethral prosthesis may include a lock-out valve (not shown) that prevents inflating agent from filling the inflatable pillow 30. After sufficient tissue in-growth has been completed.
  • the lock-out valve may be released to allow the inflatable pillow to
  • the patient may perform the method reported herein without the assistance of a clinician. Further, compression and inflation of the inflatable pillow 30 places no additional stress on the substrate 20 because compressing the pillow actually reduces stress on the substrate.
  • the urinary prosthesis 10 may be implanted in such a
  • the pillow allows a consistent pressure to be maintained on a portion of the urethra over time regardless of any changes that

Landscapes

  • Health & Medical Sciences (AREA)
  • Urology & Nephrology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une prothèse urétrale (10) comprenant un substrat (20), un coussinet gonflable (30) fixé à ce substrat (20), un réservoir sous pression (110) en communication fluidique avec le coussinet, et un régulateur d'écoulement (70). Lors d'une compression du coussinet gonflable (30), un agent de gonflement est transféré du coussinet gonflable (30) au réservoir sous pression (110). Après la compression, l'agent de gonflement retourne dans le coussinet gonflable (30). Cette prothèse urétrale (10) peut être implantée de sorte que le coussinet gonflable (30) empêche une évacuation de liquide accidentelle à partir de la vessie d'un patient.
PCT/US2003/012742 2003-04-24 2003-04-24 Prothese de sphincter uretral masculin WO2004096087A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/US2003/012742 WO2004096087A1 (fr) 2003-04-24 2003-04-24 Prothese de sphincter uretral masculin
AU2003228679A AU2003228679A1 (en) 2003-04-24 2003-04-24 Male urethral sphincter prosthesis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2003/012742 WO2004096087A1 (fr) 2003-04-24 2003-04-24 Prothese de sphincter uretral masculin

Publications (1)

Publication Number Publication Date
WO2004096087A1 true WO2004096087A1 (fr) 2004-11-11

Family

ID=33415189

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2003/012742 WO2004096087A1 (fr) 2003-04-24 2003-04-24 Prothese de sphincter uretral masculin

Country Status (2)

Country Link
AU (1) AU2003228679A1 (fr)
WO (1) WO2004096087A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004027458A1 (de) * 2004-06-04 2006-01-19 Fink, Thomas, Dr. Satin-Port-System suburethrales adjustierbares transobturatorielles Inkontinenz-Port-System
WO2013165564A1 (fr) * 2012-05-04 2013-11-07 Ams Research Corporation Sphincter artificiel passif
US8617050B2 (en) 2009-06-08 2013-12-31 Coloplast A/S Anatomical augmentation device
US8784296B2 (en) 2010-09-07 2014-07-22 Coloplast A/S Angled surgical introducer
US9402705B2 (en) 2007-07-30 2016-08-02 Boston Scientific Scimed, Inc. Apparatus and method for the treatment of stress urinary incontinence

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4386601A (en) * 1981-08-12 1983-06-07 Medical Engineering Corporation Artificial sphincter
US4587954A (en) * 1983-12-29 1986-05-13 Habley Medical Technology Corporation Elastomeric prosthetic sphincter
US4682583A (en) * 1984-04-13 1987-07-28 Burton John H Inflatable artificial sphincter
EP0409592A1 (fr) * 1989-07-21 1991-01-23 American Medical Systems, Inc. Système de sphincter artificiel implantable
DE19511998A1 (de) * 1995-03-31 1996-10-02 Eska Medical Gmbh & Co Implantierbare Vorrichtung zum wahlweisen Öffnen und Verschließen von rohrförmigen Körperorganen, insbesondere der Harnröhre
WO2000018319A1 (fr) * 1998-09-30 2000-04-06 Burger, Nicolaas, Daniel, Lombard Fronde susceptible de se dilater destinee a l'incontinence urinaire
US6117067A (en) * 1998-03-10 2000-09-12 Gil-Vernet; Josema Device for the height-adjustable fixing and support of internal anatomical organs

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4386601A (en) * 1981-08-12 1983-06-07 Medical Engineering Corporation Artificial sphincter
US4587954A (en) * 1983-12-29 1986-05-13 Habley Medical Technology Corporation Elastomeric prosthetic sphincter
US4682583A (en) * 1984-04-13 1987-07-28 Burton John H Inflatable artificial sphincter
EP0409592A1 (fr) * 1989-07-21 1991-01-23 American Medical Systems, Inc. Système de sphincter artificiel implantable
DE19511998A1 (de) * 1995-03-31 1996-10-02 Eska Medical Gmbh & Co Implantierbare Vorrichtung zum wahlweisen Öffnen und Verschließen von rohrförmigen Körperorganen, insbesondere der Harnröhre
US6117067A (en) * 1998-03-10 2000-09-12 Gil-Vernet; Josema Device for the height-adjustable fixing and support of internal anatomical organs
WO2000018319A1 (fr) * 1998-09-30 2000-04-06 Burger, Nicolaas, Daniel, Lombard Fronde susceptible de se dilater destinee a l'incontinence urinaire

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004027458A1 (de) * 2004-06-04 2006-01-19 Fink, Thomas, Dr. Satin-Port-System suburethrales adjustierbares transobturatorielles Inkontinenz-Port-System
US9402705B2 (en) 2007-07-30 2016-08-02 Boston Scientific Scimed, Inc. Apparatus and method for the treatment of stress urinary incontinence
US10413392B2 (en) 2007-07-30 2019-09-17 Boston Scientific Scimed, Inc. Apparatus and method for the treatment of stress urinary incontinence
US8617050B2 (en) 2009-06-08 2013-12-31 Coloplast A/S Anatomical augmentation device
US8784296B2 (en) 2010-09-07 2014-07-22 Coloplast A/S Angled surgical introducer
WO2013165564A1 (fr) * 2012-05-04 2013-11-07 Ams Research Corporation Sphincter artificiel passif

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