JP7044239B2 - Urethral indwelling device - Google Patents

Description

The present invention relates to a urethral indwelling device to be indwelled in the urethra.

When the urethra is closed or narrowed due to enlargement of the prostate or the like and urination disorder occurs, a treatment is performed in which a urethral stent for expanding the urethra is installed in the urethra.

Such a urethral stent is disclosed in, for example, Patent Documents 1 to 3 below.

Japanese Patent Application Laid-Open No. 2003-52835 Japanese Patent Publication No. 2008-543499 Japanese Patent No. 4025648

However, the urethral stent disclosed in Patent Documents 1 to 3 has a complicated structure, and it is premised that the medical staff also performs the indwelling treatment in the urethra, and the user indwells the stent by himself / herself. It's difficult to do.

The present invention has been made in view of such a problem, has a simple structure, and can be easily placed in the urethra by the user or taken out from the urethra by himself / herself. The purpose is to provide a urethral indwelling device.

The urethral stent according to the present invention for solving the above-mentioned problems is a thin rod-shaped urethral stent indwelled in the urethra to widen the prostatic urethra, in which the prostatic part and the sphincter muscle part are integrally formed in order from the tip side. The prostatic region is a protrusion formed at the boundary with the sphincter muscle, and forms a gap between the inner wall of the urethra and the prostatic region at the time of indwelling. The bulbar urethral region comprises a prostatic projection, the bulbar urethral region comprises a bulbar urethral projection formed at the boundary with the sphincter muscle, and the prostatic projection and the bulbar urethral projection are flat projections. It is characterized by being.

Further, the urethral indwelling device according to the present invention includes the urethral stent, an auxiliary tip that is placed in the urethra on the exit side of the urethral stent and prevents the urethral stent from coming out of the urethra, and the urethral stent. It is characterized by comprising a connecting string for connecting the auxiliary chip and the auxiliary chip.

According to the urethral indwelling device according to the present invention, the structure is simple, and the user can easily place it in the urethra or take it out from the urethra by himself / herself.

FIG. 1 is a plan view of the urethral indwelling device according to the present embodiment. FIG. 2 is a front view of the urethral indwelling device according to the present embodiment. FIG. 3 is a diagram showing an indwelling state of the urethral indwelling device according to the present embodiment. FIG. 4 is a plan view of the auxiliary chip according to the first modification of the present embodiment. FIG. 5 is a plan view of the urethral stent according to the second modification of the present embodiment. FIG. 6 is a diagram showing an indwelling state of the urethral indwelling device according to the third modification of the present embodiment.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a plan view of the urethral indwelling device according to the present embodiment. FIG. 2 is a front view of the urethral indwelling device according to the present embodiment. FIG. 3 is a diagram showing an indwelling state of the urethral indwelling device according to the present embodiment.

The urethral indwelling tool 1 includes a urethral stent 10, an auxiliary tip 30, and a connecting string 40 that connects the urethral stent 10 and the auxiliary tip 30. The urethral stent 10 is located mainly in the prostatic urethra when placed in the urethra and functions to widen the prostatic urethra and secure a urinary passage.

The urethral stent 10 is a rod-shaped member integrally molded from an epoxy resin, comprising a bladder portion 11, a prostate portion 15, a sphincter portion 21, and a bulbous urethral portion 25, which are formed in order from the distal end side. The sphincter portion 21 and the prostate portion 15 extend substantially linearly, but the bladder portion 11 and the bulbar urethral portion 25 are substantially on the same plane and on the same side with respect to the sphincter portion 21 and the prostate portion 15. It is bent gently by about 45 °.

The bladder portion 11 has a thin rod shape with a length of about 10 mm and a diameter of 2 to 4 mm, and the sphincter portion 21 also has a thin rod shape with a length of about 10 mm and a diameter of 2 to 4 mm. The bulb urethral portion 25 has a length of about 10 mm and includes a bulb urethral flat protrusion 26. The bulb urethral flat protrusion 26 is a portion flattened and protrudes from the central portion, and has a substantially disk shape. The maximum diameter of the bulb urethral flat protrusion 26 is 6 to 8 mm, and the thickness is 2 to 4 mm.

The prostate portion 15 includes a first prostate flat protrusion portion 16, a second prostate flat protrusion portion 17, and a thin rod portion 18. The first prostate flat protrusion 16 is located at the base of the thin rod portion 18, which is the boundary with the sphincter muscle portion 21, and the second prostate flat protrusion portion 17 is the tip of the thin rod portion 18 and the first prostate flat protrusion portion. It is located between 16 and 16.

The prostate flat protrusions 16 and 17 have substantially the same shape as the bulb urethral flat protrusions 26, and have a substantially disk shape with a maximum diameter of 6 to 8 mm and a thickness of 2 to 4 mm, which protrudes flatly from the thin rod portion 18. be. The prostate portion 15 has a length of about 30 mm, and the diameter of the thin rod portion 18 is 2 to 4 mm. The flat protrusion 16 of the first prostate and the flat protrusion 17 of the second prostate are separated by 3 mm.

In the present embodiment, the first prostate flat protrusion 16, the second prostate flat protrusion 17, and the bulbar urethral flat protrusion 26 are located on the same plane, and the bladder portion 11 is also bent on this same plane. There is. As described above, if the flat protrusions 16, 17, and 26 and the bent bladder portion 11 are formed on the same plane, the shape of the urethral stent 10 can be simplified and the manufacturing cost can be reduced.

When the urethral stent 10 having such a configuration is placed in the human urethra, the bladder portion 11 is located in the bladder, the prostate portion 15 is located in the prostate urethra, and the sphincter muscle portion 21 is located in the external urethral sphincter muscle. However, the bulb urethra 25 is placed so as to be located in the bulb urethra.

The auxiliary tip 30 is placed in the urethra on the exit side of the urethral stent 10, assists the urethral stent 10 from coming out of the urethra when urinating, and assists in removing the urethral stent 10 from the urethra. Is also used. Like the urethral stent 10, the auxiliary tip 30 is integrally molded from an epoxy resin and has a flat elongated plate shape having a thickness of 2 to 4 mm, a width of 6 to 8 mm, and a length of about 25 mm.

The connecting string 40 is a nylon string that connects the urethral stent 10 and the auxiliary tip 30. Both ends of the connecting string 40 are integrally fixed while extending the inside of the urethral stent 10 and the auxiliary tip 30 over substantially the entire length. Such a connecting structure is realized by integrally resin-molding the urethral stent 10 and the auxiliary tip 30 with the connecting string 40 extending inside.

By adopting such a connecting structure, the connecting string 40 is firmly fixed to the urethral stent 10 and the auxiliary tip 30 and does not come off. Therefore, the urethral stent 10 inserted in the back of the urethra, which will be described later, is taken out. The work can be done easily and surely.

Further, even if the urethral stent 10 or the auxiliary tip 30 is damaged in the urethra for some reason, there is a high possibility that the damaged debris is connected by the connecting string 40, and the debris removal work is safe and easy. It can be carried out.

The configuration of the urethral indwelling tool 1 has been described above, and subsequently, the usage mode of the urethral indwelling tool 1 will be described. First, a procedure for inserting and indwelling the urethral indwelling tool 1 into the urethra will be described.

Upon insertion, the user inserts the bladder portion 11 of the urethral stent 10 into the external urethral meatus E, which is the entrance of the urethra, and subsequently picks the urethral stent 10 so that the entire urethral stent 10 enters the urethra. Then push it into the back.

With the entire urethral stent 10 in the urethra, the bladder 11 is still located in the pendulum urethra D. From this state, the user moves the urethral stent 10 to the back of the urethra by pushing the portion of the spherical urethral flat protrusion 26 mainly from the outside of the penis into the back by milking.

As a result, the bladder portion 11 at the tip is sequentially pushed from the bulb urethra C to the prostatic urethra B. Here, at the external urethral sphincter K, the urethra is narrow and tight, and the urethra is curved from the bulb urethra C to the prostatic urethra B, so it is necessary to carefully push it in.

As described above, in the present embodiment, the bladder portion 11 at the tip is curved by about 45 ° with respect to the prostate portion 15, and the curved bladder portion 11 and the flat protrusions 16, 17, and 26 are flush with each other. It's above.

Therefore, while maintaining the posture of the urethral stent 10 so that the flat protrusions 16, 17, and 26 are in the vertical state, the user pushes the urethral stent 10 into the bending direction of the urethra at the external urethral sphincter muscle K. , The bending directions of the urethral stent 10 coincide with each other, and the bladder portion 11 smoothly enters the urethral portion B of the prostate.

Subsequently, when the portion of the external urethral sphincter muscle K is passed through the flat protrusion 17 of the second prostate, the user needs to push the urethral stent 10 slightly strongly. Further, the bladder portion 11 passes through the prostate portion urethral tract B, passes through the internal urethral sphincter muscle J located at the entrance of the bladder A, and the first prostate flat protrusion portion 16 passes through the portion of the external urethral sphincter muscle K. At about the same timing, the user needs to push the urethral stent 10 harder at this time.

When the first prostate flat protrusion 16 passes through the external urethral sphincter K, the external urethral sphincter K is the first because the bulb urethral flat protrusion 26 of the bulb urethra 25 is located outside the external urethral sphincter K. It is in a state of being sandwiched between the flat protrusion portion 16 of the prostate and the flat protrusion portion 26 of the bulbous urethra. This state shown in FIG. 3 is a state in which the urethral stent 10 is placed in the urethra.

On the other hand, when the urethral stent 10 is inserted into the urethra and pushed into the back of the auxiliary tip 30, the auxiliary tip 30 is pulled by the connecting string 40 and pulled to the external urethral meatus. When the urethral stent 10 is pushed further into the urethra by milking, the auxiliary tip 30 located at the external urethral meatus is pulled by the connecting string 40 and enters the urethra as it is. You may insert it inside.

The auxiliary tip 30 that has entered the urethra is pulled through the connecting string 40 for the urethral stent 10 to be pushed inward, and in the above-mentioned indwelling state, the auxiliary tip 30 is the boundary between the bulb urethra C and the pendulum urethra D. Located around.

In this indwelling state, when the urethral stent 10 tries to advance to the back, the bulbous urethral flat protrusion 26 collides with the external urethral sphincter muscle K and cannot easily advance. The flat protrusion 16 collides with the external urethral sphincter K, and the curved tip of the bladder 11 collides with the internal urethral sphincter J, and cannot move easily.

That is, the indwelling urethral stent 10 does not move easily in the urethra and becomes a stable state. For example, even if a force acts on the urethral stent 10 in the direction of pushing out due to the urine flowing out of the urethra during urination, the urethral stent 10 is not easily pushed out.

Then, in the indwelling state, the first prostatic flat protrusion 16 and the second prostatic flat protrusion 17 are located in the prostatic urethra B, the prostatic urethra B is widened, and the passage of urine can be reliably secured. can.

Here, if the prostatic urethra B is expanded in all directions in the radial direction as in the conventional hollow tubular stent, a feeling of oppression is felt and the burden on the user is large. However, in the present embodiment, the prostatic urethra is heavy. Since the protrusions 16 and 17 that widen B are flat protrusions, the burden on the user is significantly reduced compared to the case where the prostate urethra B is widened in all directions, and the urinary passage is surely performed. Can be secured.

Further, in the present embodiment, in the indwelling state, the second prostate is located 3 mm behind the urethra of the first prostatic flat protrusion 16 that widens the urethra at the end of the external urethral sphincter K side of the prostatic urethra B. The flat protrusion 17 is located and also widens the urethra.

The exit of the ejaculatory duct L connected to the seminal vesicles is located in the sperm hill about 10 mm away from the exit side end of the prostate urethra B, and in the indwelling state, the first prostatic flat protrusion 16 and the second The exit of the ejaculatory duct L will be located in the gap space between the flat protrusion of the prostate and the inner wall surface of the urethra. Therefore, the attachment of the urethral stent 10 does not block the outlet of the ejaculatory duct L, and the physical load on the user can be relieved.

Subsequently, a procedure for taking out the indwelling urethral indwelling tool 1 will be described. In the indwelling state shown in FIG. 3, the bulbous urethral flat protrusion 26 located on the most exit side of the urethra is deeply pushed to a position where it is in close contact with the external urethral sphincter muscle K, and the bulbous urethral flat protrusion 26 is pushed into the urethra by milking. It is difficult to push it to the exit side of.

Therefore, the user pushes the auxiliary tip 30 located near the boundary between the bulb urethra C and the pendulum urethra D toward the outlet side by milking, so that the urethral stent 10 is also pulled through the connecting string 40 and the urethra is pulled. Move to the exit side of. After the auxiliary tip 30 goes out of the urethra, the urethral stent 10 can be pulled out directly from the urethral outlet by pulling the connecting string 40.

Although the present embodiment has been described in detail above, according to the present embodiment, the structure of the urethral indwelling tool 1 is simple, and the method of inserting into the urethra and the method of taking out from the urethra are also simple. It is possible for a general user to place the urethral indwelling device 1 in the urethra or remove it from the urethra by himself / herself.

Further, the urethral indwelling tool 1 includes an auxiliary tip 30 connected to the urethral stent 10 by a connecting string 40, and the auxiliary tip 30 is located near the boundary between the bulb urethra C and the urethral urethra D at the time of indwelling. Therefore, it is possible to prevent the urethral stent 10 placed in the urethra from coming out toward the outside when urinating, and when the urethral indwelling tool 1 is taken out, the urethral stent 10 is used by using the auxiliary tip 30. By pulling, the urethral stent 10 can be easily removed.

Further, since the connecting string 40 extends inside the urethral stent 10 and the auxiliary tip 30 and is integrally connected, even if the urethral stent 10 or the auxiliary tip 30 is damaged in the urethra. Since the fragments are connected by the connecting string 40, the fragments can be easily taken out of the body.

Further, in the urethral stent 10, the three flat protrusions 16, 17, and 26 are located on the same surface, and the bladder portion 11 and the bulbous urethral portion 25 are also located on the surface on which the flat protrusions 16, 17, and 26 are located. Since it is curved on the same surface, the bending direction of the bladder portion 11 can be easily grasped by touching the flat protrusions 16, 17, and 26 when the user milks. That is, the user can easily grasp the posture of the urethral stent 10 at the time of milking, and the urethral stent 10 can be easily inserted into the urethra.

Subsequently, a modification 1 of the present embodiment will be described. FIG. 4 is a plan view of the auxiliary chip according to the first modification. The first modification is characterized in that a stick-shaped auxiliary tip 30'is used instead of the auxiliary tip 30 according to the above embodiment, and a locking ring 35 is further provided on the root side of the auxiliary tip 30'.

The auxiliary tip 30'is a rod-shaped member made of silicon, and is used by being inserted into the urethra in the same manner as the auxiliary tip 30. The locking ring 35 is made of a stocking material whose surface is waterproofed with silicon and has high elasticity.

The locking ring 35 is used by being hooked on the glans penis edge portion when the urethral stent 10 and the auxiliary tip 30'are placed in the urethra. This can prevent the urethral stent 10 from getting too far into the urethra, and also pulls the locking ring 35 located outside the urethra when removing the urethral stent 10 and the auxiliary tip 30'. It can be easily pulled out.

Subsequently, a modification 2 of the present embodiment will be described. FIG. 5 is a plan view of the urethral stent 10'according to the modified example 2. In the second modification, the urethral stent 10'with a different shape is adopted instead of the urethral stent 10 according to the above embodiment.

The urethral stent 10'has a similar shape to the urethral stent 10 except that it does not have a bladder, and includes a prostate 15', a sphincter 21', and a bulb urethral 25'. The prostate portion 15' includes a first prostate flat protrusion 16', a second prostate flat protrusion 17', and a thin rod portion 18', and the bulb urethral portion 25'is a bulb urethral flat protrusion 26'. 'Equipped with.

According to this modification 2, since the tip has a simple structure that does not reach the bladder, the psychological hurdle when using the urethral indwelling device 1 is lowered while obtaining the action effect of expanding the prostatic urethral part B. Even beginners can feel free to use it.

Subsequently, a modification 3 of the present embodiment will be described. FIG. 6 is a diagram showing an indwelling state of the urethral indwelling tool 1'according to the modified example 3. The urethral indwelling tool 1'adopts a longer connecting string 40', and the connecting string 40' is extended to the opposite side of the urethral stent 10 of the auxiliary tip 30'', and a small tip tip 31 is further attached to the tip thereof. It is characterized by being installed. The auxiliary tip 10'according to the modification 3 is the same as the modification 2.

Therefore, in the indwelling state of the urethral indwelling tool 1', the auxiliary tip 30'is located near the external urinary meatus E, which is the exit in the urethra, and is larger than the auxiliary tip 30' of the connecting string 40'. The portion and the tip 31 are always out of the urethra. According to this modification, the work of pulling out the urethral stent and the auxiliary tip from the urethra can be easily performed.

Although the embodiments of the present invention have been described above including modifications, the embodiments of the present invention are not limited to the above embodiments, and various modifications can be made without departing from the gist of the present invention. Is. For example, the material, shape, size, etc. of the members constituting the urethral indwelling device can be changed as appropriate, and in particular, the shape and size of the bladder, prostate, sphincter, and bulb urethral part of the urethral stent depend on individual differences. It may be changed as appropriate.

Further, in the above embodiment, an epoxy resin is used as the material of the urethral stent and the auxiliary tip, but a resin other than the epoxy may be used, or a material other than the resin may be used. For example, it may be a glass urethral stent. However, considering the manufacturing cost and strength, it is desirable that the urethral stent and the auxiliary tip are integrally molded from the same material.

When glass is used as the material, the temperature becomes high during glass molding, and it is difficult to pass the connecting string integrally inside. Therefore, even if the connecting string is attached to the surface of the urethral stent and the auxiliary tip. good.

Further, when the connecting string is attached, the connecting string can be firmly fixed by attaching the integrated object to the surface of the glass through the connecting string inside the epoxy resin sheet. In addition, as a method for fixing the connecting string, a hole may be formed in the urethral stent and the connecting string may be passed through the hole to connect the urethral stent.

Further, in the above embodiment, the prostate portion of the urethral stent is provided with two flat protrusions, a first prostate flat protrusion and a second prostate flat protrusion, but only the first prostate flat protrusion may be used. Further, the flat protrusions of the prostate and the bulbar urethra may have other shapes such as a rod shape instead of a flat shape, and by locally expanding the prostatic urethra, a gap that becomes a passage for urine. It suffices as long as it is a protrusion having a shape that can secure the above.

1 Urethral indwelling device 10 Urethral stent 11 Bladder part 15 Prostate 16 First prostatic flat protrusion 17 Second prostatic flat protrusion 18 Thin rod 21 Constrictor muscle 25 Ball urethra 26 Ball Urethral flat protrusion 30 Auxiliary tip 35 Locking ring 40 Connecting string A Bladder B Prosthesis urethra C Ball urethra D Psycho-urethra E External urethral opening J Internal urethral sphincter K External urethral sphincter L Ejaculatory duct

Claims (5)

In a bar-shaped urethral stent that is placed in the urethra and widens the prostatic urethra,
It has at least a prostate, a sphincter, and a bulbous urethra that are integrally molded from the tip side.
The prostate portion is a protrusion formed at a boundary portion with the sphincter muscle portion, and includes a prostate protrusion portion that forms a gap between the inner wall of the urethra and the prostate portion at the time of placement.
The bulb urethral portion comprises a bulb urethral protrusion formed at a boundary portion with the sphincter muscle portion .
A urethral stent in which the prostatic protrusion and the bulb urethral protrusion are flat protrusions . The urethral stent according to claim 1 , wherein the prostatic protrusion and the bulb urethral protrusion are located on the same plane. The prostate portion is formed so as to be located on the same plane at a predetermined distance from the prostate protrusion to the distal end side, and a gap between the inner wall of the urethra and the prostate portion at the time of indwelling. 2. The urethral stent according to claim 2 , further comprising a second prostate flattening process forming a. The urethral stent according to any one of claims 1 to 3 and
An auxiliary tip that is placed in the urethra on the exit side of the urethral stent and prevents the urethral stent from coming out of the urethra.
A connecting string connecting the urethral stent and the auxiliary tip,
A urethral indwelling device characterized by being equipped with. The urethral indwelling device according to claim 4 , wherein the connecting string is integrally fixed to the urethral stent and the auxiliary tip in a state where the inside of the urethral stent and the auxiliary tip extends over substantially the entire length. ..

Images