Apparatus and method for treating female urinary incontinence

Abstract

The present invention provides a surgical implant and method for supporting the urethra where the implant includes a suburethral support suspended between two soft tissue anchors. The surgical implant is introduced into at least one incision made on the upper wall of a vagina with the first soft tissue anchor inserted on a first side of the urethra behind the pubic bone, and the second soft tissue anchor inserted on a second side of the urethra behind the pubic bone, such that the suburethral support is suspended from the soft tissue anchors and supports the urethra. Each of the first and second soft tissue anchors are inserted in, and fix in, the soft tissue of the perineum without penetrating the obturator foramen.

1 . A method of supporting a urethra comprising the steps of 
 introducing a surgical implant comprising first and second soft tissue anchors and a suburethral support portion therebetween into at least one incision made on the upper wall of a vagina,    inserting the first soft tissue anchor on a first side of the urethra behind the pubic bone, and    inserting the second soft tissue anchor on a second side of the urethra behind the pubic bone, such that the suburethral support is suspended from the soft tissue anchor and supports the urethra,    wherein each of the first and second soft tissue anchors are inserted in and fix in the soft tissue of the perineum without penetrating the obturator foramen.    
     
     
         2 . The method as recited in  claim 1  wherein at least one of the first and second tissue anchors comprises a central portion and retaining means wherein the retaining means comprise a plurality of projections, the projections extending radially from the central portion along a substantial portion of the length of the central portion allowing fixation of the anchor at a plurality of layers within the soft tissue of the perineum.  
     
     
         3 . The method as recited in  claim 1  wherein at least one of the first and second tissue anchors comprises biocompatible glue.  
     
     
         4 . The method as recited in  claim 1  wherein the first soft tissue anchor is inserted on a first side on the urethra behind the pubic bone in a lateral direction away from the urethra and positioned in the soft tissue of the perineum, and the second soft tissue anchor is inserted on a second side of the urethra in an opposite lateral direction from the first soft tissue anchor and away from the urethra and positioned in the soft tissue of the perineum, such that the suburethral support is suspended from the first and second soft tissue anchors and supports the urethra.  
     
     
         5 . The method as recited in  claim 1  wherein the surgical implant does not penetrate the endopelvic fascia.  
     
     
         6 . The method as recited in  claim 1  further comprising providing at least one of the first and second soft tissue anchors with portions to grip the soft tissue of the perineum at multiple layers.  
     
     
         7 . The method as recited in  claim 1  wherein the surgical implant comprises polymer tape.  
     
     
         8 . The method as recited in  claim 1  wherein the surgical implant comprises bioabsorbable material.  
     
     
         9 . A method of supporting a urethra comprising the steps: 
 introducing a surgical implant into at least one incision made on the upper wall of a vagina the surgical implant comprising first and second ends and a suburethral support section therebetween;    inserting a first end of the surgical implant on a first side of the urethra and positioning the first end into soft tissue of the perineum without penetrating the obturator foramen; and    inserting a second end of the surgical implant on a second side of the urethra and positioning the second end into the soft tissue of the perineum without penetrating the obturator foramen such that the suburethral support section is positioned under the urethra and provides support thereto.    
     
     
         10 . The method of  claim 9  wherein the surgical implant does not penetrate the endopelvic fascia.  
     
     
         11 . A method of supporting a urethra, comprising: 
 mechanically coupling, with a surgical implant, a first soft tissue portion of a perineum on a first side of the urethra to a second soft tissue portion of the perineum on a second side of the urethra, wherein the urethra is positioned between the first and second tissue portion, and    orientating a portion of the surgical implant underneath the urethra to provide support thereto, wherein the obturator foramen is not penetrated.    
     
     
         12 . The method as recited in  claim 11 , further comprising causing a portion of the surgical implant to grip at least one of the first and second tissue portions.  
     
     
         13 . The method as recited in  claim 11  wherein the surgical implant does not penetrate the endopelvic fascia.  
     
     
         14 . A method of supporting a urethra comprising: 
 positioning a surgical implant in a perineum to mechanically couple a first tissue portion of the perineum on a first side of the urethra to a second tissue portion of the perineum on a second side of the urethra, wherein the urethra is positioned between the first and second tissue portions; and    positioning a portion of the surgical implant underneath the urethra to provide support thereto,    wherein substantially all of the mechanical coupling is provided by interaction of the first and second tissue portions with respective portions of the surgical implant.