Bladder tissue modification for overactive bladder disorders

Abstract

Regions of tissue having reduced electrical propagation are created in a bladder to affect its electrical or mechanical properties. To create these tissue regions, a tubular device is advanced through the urethra leading to the interior of the bladder, a distal expandable structure of the device is expanded to contact the inner wall of the bladder, and electrodes or other active energy delivery elements of the device are activated to deliver ablation energy. The electrodes or other active energy delivery elements are disposed over the expandable structure which is shaped to conform to the interior of the bladder. The inner wall of the organ is ablated in a predetermined pattern. The same or other electrodes disposed over the expandable structure can used to electrically map the bladder. This map of electrical activity can be used to create the predetermined pattern.

What is claimed is: 
     
         1 . A device for treating a disorder in a hollow bodily organ, the device comprising:
 a shaft advanceable through a bodily channel of a subject to reach a cavity of the organ;   an ablation member having a collapsed configuration for advancement through the bodily channel and an expanded configuration adapted to create a predetermined pattern of electrically isolated tissue regions in an inner wall of the hollow bodily organ, with each electrically isolated tissue region being defined by at least one continuous ablation line and being no larger than half of a total inner surface area of the bodily organ.   
     
     
         2 . The device of  claim 1 , further comprising an expandable member coupled to a distal end of the shaft, the expandable member having a collapsed configuration advanceable through the bodily passage to reach the cavity of the organ and an expanded configuration configured to contact an inner wall of the organ when the expandable member is advanced therein. 
     
     
         3 . The device of  claim 2 , wherein the ablation member is disposed over the expandable member. 
     
     
         4 . The device of  claim 2 , wherein the expandable member comprises an inflatable balloon. 
     
     
         5 . The device of  claim 4 , wherein the inflatable balloon is configured to be inflated with a liquid or a gas. 
     
     
         6 . The device of  claim 2 , wherein the expandable member is disposed over the distal end of the shaft, and the distal end of the shaft is telescopic to extend in length as the expandable member transitions from the collapsed to the expanded configuration. 
     
     
         7 . The device of  claim 2 , wherein the expandable member is configured to conform to the shape of the inner wall of the bodily organ when in the expanded configuration within the bodily organ. 
     
     
         8 . The device of  claim 1 , wherein the ablation member comprises at least one longitudinal elongate member configured to generate the at least one continuous ablation line on the inner wall of the hollow bodily organ. 
     
     
         9 . The device of  claim 8 , wherein the at least one longitudinal elongate member is parallel to a longitudinal axis of the shaft when the ablation member is in the expanded configuration. 
     
     
         10 . The device of  claim 8 , wherein the at least one longitudinal elongate member is parallel to a longitudinal axis of the hollow bodily organ when the ablation member is in the expanded configuration. 
     
     
         11 . The device of  claim 1 , wherein the ablation member comprises at least one latitudinal elongate member configured to generate the at least one continuous ablation line on the inner wall of the hollow bodily organ. 
     
     
         12 . The device of  claim 11 , wherein the at least one latitudinal elongate member is transverse to a longitudinal axis of the shaft when the ablation member is in the expanded configuration. 
     
     
         13 . The device of  claim 11 , wherein the at least one latitudinal elongate member is transverse to a longitudinal axis of the hollow bodily organ when the ablation member is in the expanded configuration. 
     
     
         14 . The device of  claim 1 , wherein the ablation member comprises at least one longitudinal elongate member and at least one longitudinal elongate member arranged to be transverse to one another when the ablation member is in the expanded configuration, and wherein one or more of the at least one longitudinal elongate member or the at least one longitudinal elongate member is configured to generate the at least one continuous ablation line on the inner wall of the hollow bodily organ. 
     
     
         15 . The device of  claim 1 , wherein the ablation member is configured to conform to the shape of the inner wall of the bodily organ when in the expanded configuration within the bodily organ. 
     
     
         16 . The device of  claim 1 , wherein the predetermined pattern of electrically isolated tissue regions created by ablation member in the expanded configuration comprises a plurality of substantially continuous ablation lines in the inner wall of the bodily organ. 
     
     
         17 . The device of  claim 16 , wherein the plurality of substantially continuous ablation lines comprises at least one of circumferential lines, longitudinal zag lines, or broken lines. 
     
     
         18 . The device of  claim 15 , wherein the plurality of substantially continuous ablation lines occupies no more than 10% of a total inner surface area of the hollow bodily organ in the predetermined pattern. 
     
     
         19 . The device of  claim 1 , wherein the ablation member comprises one or more of an RF energy applicator, a cryoablation member, a photoablative member, a microwave energy applicator, a chemical agent delivery member, an ultrasound energy applicator, or a mechanical scoring member. 
     
     
         20 . The device of  claim 1 , wherein the hollow bodily organ is selected from the group comprising a urinary bladder, a kidney, a vagina, a uterus, a fallopian tube segment, a colon segment, a large intestine segment, a small intestine segment, a stomach, an esophagus segment, a gall bladder, a bronchus, and an alveolus of the lung.