IMPLANT

Abstract

An implant with which a urinary tract can be treated in a simple and reliable manner is achieved in that a wire structure of an implant can be introduced into the urethra in a folded state with a distal end in the lead. The wire structure is unfolded inside the urethra for the treatment of the tissue. The ischemic pressure of the wires on the surrounding tissue results in denaturation. At least one further device for constricting or cutting into tissue is positioned on the wire structure. This at least one further device is designed in such a way that it exerts a local ischemic pressure on the median lobe in the unfolded state of the implant.

Claims

1. An implant for the treatment of a urinary tract of a person by applying a local ischemic pressure to the tissue of urinary organs by means of a wire structure having at least two wires, wherein the implant can be introduced into the urethra in a folded state with a distal end in the lead and unfolds in the urethra to form the wire structure for the treatment of the tissue, which comprises at least one further means for constricting or cutting into tissue, wherein this means is positioned on the wire structure in such a way that it exerts a local ischemic pressure on a median lobe of the person.

2. The implant as claimed in claim 1, wherein the means for constricting or cutting is a wire made from a shape memory material or is a thread.

3. The implant as claimed in claim 2, wherein the wire can be introduced into the urethra in a folded state relative to the implant and unfolds in the urethra so as to form a predetermined angle with the wire structure.

4. The implant as claimed in claim 1, wherein the means for constricting or cutting is intertwined with a wire of the wire structure.

5. The implant as claimed in claim 2, wherein the wire is bent at least in some section or sections, wherein the wire is bent convexly relative to a longitudinal axis of the implant, thus enabling the bent wire to be laid around the median lobe.

6. The implant as claimed in claim 2, wherein the thread is designed as a loop, wherein this loop can be laid around the median lobe.

7. The implant as claimed in claim 6, wherein a diameter of the loop can be varied.

8. The implant as claimed in claim 6, wherein one end of the loop is firmly connected to the implant and the other end is guided loosely to a proximal end of the implant, wherein the size of the diameter of the loop can be varied by pulling on the loose end of the thread, and wherein, the loose end of the thread can be fixed releasably to the wire structure during treatment.

9. The implant as claimed in claim 6, wherein the thread is guided on the wire structure in at least one sleeve.

10. The implant as claimed in claim 1, wherein a further wire is arranged on the wire structure and this wire is aligned in such a way that it raises the median lobe during treatment.

11. The implant as claimed in claim 1, wherein all the wires and threads are brought together at a proximal end of the implant, and the loose wires and threads can be fixed there or can be led out to the outside through the urethra.

Description

[0015] A preferred exemplary embodiment of the present invention is explained in greater detail below with reference to the drawing. In this drawing:

[0016] FIG. 1 shows an illustration of a first exemplary embodiment of an implant,

[0017] FIG. 2 shows an illustration of a further exemplary embodiment of an implant, and

[0018] FIG. 3 shows a further illustration of the exemplary embodiment of the implant according to FIG. 2.

[0019] Possible exemplary embodiments of the invention are illustrated schematically in the figures. It should be expressly pointed out that there is no intention to restrict the invention to these exemplary embodiments. Rather, it is envisaged that the invention can also be implemented by other embodiments.

[0020] FIG. 1 illustrates an implant 10, which consists substantially of a wire structure 11. The wire structure illustrated in FIG. 1 forms a basket, which is formed by three wires 12. In this case, the wires 12 are twisted together in some section or sections. At a distal end 13, the wires 12 are of arcuate design and each run back to a proximal end 14, where they are brought together in a connecting piece 15. This connecting piece 15 positioned at the proximal end 14 is also used to make contact with a handling means 16. This handling means 16 can be designed as a thread or rod or can be part of a catheter.

[0021] Furthermore, the implant 10 has an anchoring clamp 17. This anchoring clamp 17 is of arcuate design and serves for anchoring or fixing the implant 10 in the urethra (not illustrated) during treatment. As already stated above, for treatment the implant 10 is introduced into the urethra of the patient through a catheter (not illustrated) in a folded state. At the target location, the implant 10 unfolds into the shape shown in FIG. 1. Here, the wires 12 press on the surrounding tissue of the urethra, resulting in denaturation of the tissue. After treatment, the implant 10 can be pulled back out of the urethra through the catheter, using the handling means 16. During this process, the implant 10 folds back into the catheter. To enable the implant 10 to unfold at the appropriate point in the urethra, it is produced from a shape memory material, namely Nitinol. In addition to this aforementioned material, however, other materials with a shape memory are also conceivable.

[0022] The exemplary embodiment illustrated in FIG. 1 now has a further wire 18. This wire 18 is stretched in the distal direction in the unfolded state of the implant 10. In this case, the wire 18 is fastened to one of the wires 12 of the wire structure 11. During placement or in the folded state, this wire 18 is swung inward within the folded wire structure 11. As the implant 10 is unfolded, the wire 18 swings forward in the distal direction and thus forms an angle with the other wires 12. The wire 18 is slightly bent, forming a concave curvature relative to a longitudinal axis of the implant 10. This curvature enables the wire 18 to be placed around the median lobe in a very efficient manner.

[0023] The distal end 19 of the wire can be pointed or sharp. During the treatment of the urethra by means of the wire structure 11, the wire 18 presses continuously on the median lobe or tissue (not illustrated). This application of pressure results in denaturation of the tissue. As the implant 10 is pulled out, the distal end 19 of the wire 18 moves along or through the median lobe, and this can result in an incision. Both the denaturation and the incision of the median lobe have the effect that the path is once again clear for the flow of urine.

[0024] An alternative exemplary embodiment of the implant 20 illustrated in FIG. 2 envisages that a thread 21 is fastened to at least one of the wires 12. One end of this thread 21 is firmly fastened to the wire structure 11. Another end of the thread 21 is likewise associated with the wire structure 11, but is freely movable. In this case, this free or loose end of the thread 21 is guided along a wire 12 to the proximal end 14 of the implant 20. There, the free end of the thread 21 can be grasped manually or by means of an aid.

[0025] According to the invention, provision is made for the loop formed by the thread 21 to be guided around the median lobe and for the tissue of the median lobe to be constricted by pulling on the loose end of the thread 21 (FIG. 3). This constriction can also cause denaturation of the tissue. If necessary, the tensile stress of the thread 21 is regularly increased in order to accelerate the regression of the median lobe. After completion of the treatment, the tensile force on the thread 21 is released. As the implant 20 is pulled out of the patient, the median lobe is also released from the thread 21.

[0026] The thread 21 can either be interwoven with the wires 12 of the wire structure 11 or can be guided in sleeves (not illustrated). It is conceivable for a wire 12 to be guided in a sleeve in which the thread 21 can then also be guided. In this case, both the fixed and the loose end of the thread 21 can be guided in this sleeve. Alternatively, it is also conceivable for the fixed end of the thread 21 to be arranged outside the sleeve and for only the loose end of the thread 21 to be guided through the sleeve. Another exemplary embodiment can provide for a plurality of sleeves, which are fixed to the wires 12 and through which the thread 21 is guided with at least one end, to be assigned to a wire 12 of the wire structure 11.

[0027] In addition, the exemplary embodiment of the implant 20 according to FIGS. 2 and 3 has a further wire 22. This wire 22 too is likewise fastened to the wire structure 11 and is bent obliquely upward in the distal direction. The wire 22 can preferably consist of a shape memory material and, like the thread 21, is fastened at one end to at least one of the wires 12. In the folded state of the implant 20, this wire 22 too is folded up in the wire structure 11. As the wire structure 11 is unfolded, the wire 22 moves out of the wire structure 11 and serves to press the median lobe upward during treatment, thus ensuring that the latter does not close the bladder opening. Moreover, this pushing of the median lobe upward also serves to place the thread 21 or loop around the median lobe. Owing to the curved shape of the wire 22, the latter has a certain mechanical prestress, by means of which a resilient force can be exerted on the median lobe. After completion of the treatment, the wire 22, together with the implant 20, is pulled out of the urethra.

TABLE-US-00001 List of reference signs: 10 implant 11 wire structure 12 wire 13 distal end 14 proximal end 15 connecting piece 16 handling means 17 anchoring clamp 18 wire 19 distal end 20 implant 21 thread 22 wire