Implantable hydraulic urinary sphincter system

摘要

The sphincter system includes an artificial sphincter for exerting pressure on a patient's urethra to thus maintain continence. An associated control unit controls the artificial sphincter to provide a min. differential applied pressure to the patient's urethra, for all conditions of the bladder. - The control unit pref. includes a sphincter fluid chamber contg. incompressible fluid and hydraulically coupled to the artificial sphincter, to vary the pressure it exerts. A bladder pressure sensing bulb is hydraulically coupled to the control unit, to automatically maintain the sphincter fluid at a certain pressure differential above the patient's sensed bladder pressure. EPAB- EP-119265 B An implantable hydraulic urinary sphincter system comprising: an artificial hydraulic sphincter (12) for exerting pressure on a patient's urethra (20) thereby maintaining continence; and means (16,10) for controlling said artificial sphincter by providing thereto a sphincter fluid at a controlled pressure; characterised in that said means includes sensing means (16) for sensing a condition of the patient's bladder and for establishing a reference pressure representative of said condition, and control means (10) for maintaining a substantially constant and minimal pressure difference between said controlled sphincter fluid pressure and said reference pressure, whereby continence is provided for all condition of the bladder. GBAB- GB2137505 B An implantable hydraulic urinary sphincter system comprising: an artificial sphincter means for exerting pressure on a patient's urethra, a control unit having a sphincter fluid chamber filled with incompressible fluid, said sphincter fluid chamber being hydraulically coupled to said artificial sphincter means, and wherein pressure exerted by said artificial sphincter means varies, in use, according to pressure in said sphincter fluid chamber, the control unit comprising an actuation means, associated with said sphincter fluid chamber, for manually reducing said sphincter fluid pressure thereby reducing pressure exerted by said artificial sphincter means and allowing said patient to urinate; a pressure sensor means for sensing bladder pressure, or sensing a pressure equal to the abdominal pressure plus a pressure dependent on bladder volume; a minimum pressure means for biasing fluid pressure in said sphincter fluid chamber to a set minimum pressure, and a pressure transfer means located within said control unit and directly associated with said sphincter fluid chamber and said pressure sensor means for automatically adjusting fluid pressure in said sphincter fluid chamber depending on pressure sensed by said pressure sensor means. - GB2171911 B An implantable hydraulic urinary sphincter system, comprising: an artificial sphincter: a sphincter fluid chamber, containing incompressible sphincter fluid, hydraulically coupled to said artificial sphincter so that the pressure exerted by the artificial sphincter is set by the fluid pressure in the sphincter fluid chamber; an actuation means, associated with said sphincter fluid chamber, for manually reducing the sphincter fluid pressure so as to reduce the pressure exerted by the artificial sphincter to allow a patient into whom the system has been implanted to urinate, the actuation means being arranged to be controlled by manually applying pressure to an actuation diaphragm implanted subcutaneously; and a means for adjusting fluid pressure in said sphincter fluid chamber to a set value after the system has been implanted, wherein the actuation means and the sphincter fluid chamber are mounted inside a casing, and the actuation means comprises: an actuation chamber filled with an incompressible actuation fluid, one wall of the actuation chamber containing a flexible actuation diaphragm positioned on the outer face of the casing, and at least one actuation bellows hydraulically coupled to the actuation chamber, the arrangement being such that, in use, pressing on the flexile actuation diaphragm cuases the incompressible actuation fluid to be displaced and to elongate at least one actuation bellows, and such that at least one actuation bellows when elongated presses on the sphincter fluid chamber so as to expand the sphincter fluid chamber and reduce sphincter fluid pressure. USAB- US4571749 A The system consists of an arificial urninary sphincter and a control for obtaining continence while causing the artifical sphincter to apply minimal pressure to the urethra for all conditions of the bladder. The sphincter and control automatically cause sphincter fluid pressure to increase or decrease with sensed bladder and/or abdominal pressure. - The system is manually actuated by a patient when he or she desires to urinate. The system can be filled with fluid, or the fluid pressure can be reset, after implantation without necessitating a surgical procedure.