# US 8,771,168 B2 · Transobturator methods for installing sling to treat incontinence, and related devices

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- Number: US 8,771,168 B2
- Document ID: US8771168B2
- Status: Granted
- Kind: B2
- Application number: 13/005,238
- Filed: 2011-01-12
- Published: 2011-05-05
- Granted: 2014-07-08
- Earliest claimed: 2005-02-04
- Assignees: AMS Research Corporation
- Applicants: Christian Gozzi; Peter Rehder
- Inventors: Christian Gozzi; Peter Rehder
- Web page: https://patentgrep.com/patent/US8771168B2

## CPC

- A61F 2/0045: {Support slings}
- A61B 17/06066: {Needles, e.g. needle tip configurations}
- A61B 17/06109: {Big needles, either gripped by hand or connectable to a handle}
- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 2017/0046: {with a releasable handle; with handle and operating part separable}
- A61B 2017/00805: {Treatment of female stress urinary incontinence}
- A61B 2017/06009: {having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle}
- A61B 2017/06076: {helically or spirally coiled}
- A61B 2017/06085: {having a blunt tip}
- 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 (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Described are methods of treating urinary incontinence using a urinary sling and a tissue path that passes through the obturator foramen, along with related surgical implants, devices, systems, and kits.

## Claims

### Claim 1

A method of treating incontinence in a male patient, the method comprising
providing an elongate implantable sling comprising a central support portion and two elongate end portions, the central support portion and two elongate end portions being continuous mesh,
creating an incision at the perineum of the male patient,
inserting the sling through the perineal incision,
installing the central support portion below the bulbous urethra,
attaching an end portion to an obturator membrane without making a lateral incision adjacent the patient's obturator foramen, and
approximating the urethra in a direction toward the bladder to improve coaptation of the urethra by a rhabdosphincter, without the sling placing compressive forces on the urethra.

### Claim 2 (depends on 1)

The method of claim 1, comprising placing tension on the sling to approximate pelvic tissue including the urethra, to improve sphincter function and coaptation of the urethra.

### Claim 3 (depends on 1)

The method of claim 1, wherein the sling is placed in contact with corpus spongiosum.

### Claim 4 (depends on 3)

The method of claim 3, comprising fixing the central support portion to the corpus spongiosum.

### Claim 5 (depends on 4)

The method of claim 4 comprising approximating and supporting a posterior junction between the bulbar urethra and the perineal membrane.

### Claim 6 (depends on 1)

The method of claim 1, wherein the sling comprises a widened central support portion.

### Claim 7 (depends on 6)

The method of claim 6 comprising placing the central support portion at a location below a membranous urethra.

### Claim 8 (depends on 6)

The method of claim 6 wherein the width of the central support portion is in a range from 1 to 2 centimeters.

### Claim 9 (depends on 1)

The method of claim 1 wherein the sling comprises an anchor and the anchor attaches to the obturator membrane.

### Claim 10 (depends on 1)

The method of claim 1 wherein the sling comprises a central support portion located between two opposing elongate end portions, the central support portion is integral with the end portions, and a width of the central support portion is the same as a width of the elongate end portions.

### Claim 11 (depends on 1)

The method of claim 1 comprising placing tension on the end portions of the sling to approximate the urethra in a direction toward the bladder by a distance in a range from 1 to 5 centimeters.

### Claim 12 (depends on 1)

The method of claim 1 comprising approximating and supporting a posterior junction between the bulbar urethra and the perineal membrane.

### Claim 13 (depends on 1)

The method of claim 1 comprising placing the central support portion at a location below a membranous urethra.