1. Field of the Invention
The present invention relates to external incontinence devices and, more particularly, to external incontinence devices configured for the human female anatomy.
2. Brief Discussion of the Related Art
Female urinary incontinence is a common medical problem and is, in many cases, attempted to be managed with absorbent diapers or in-dwelling urinary catheters, either urethral or suprapubic. Diapers are associated with a high rate of skin breakdown and decubitis ulcer formation while in-dwelling urinary catheters are a leading cause of urinary tract infections. Accordingly, there has been a great demand for non-invasive external incontinence devices for collecting urine from females without exposing the body to constant urine contact.
There have been many attempts to provide female external incontinence devices as exemplified by U.S. Pat. No. 3,528,423 to Lee, No. 4,484,917 to Blackmon, No. 4,563,183 to Barrodale et al, No. 4,568,339 to Steer, No. 4,681,572 to Tokarz, No. 4,822,347 to MacDougall, No. 4,904,248 to Vaillancourt, No. 4,986,823 to Anderson et al, No. 5,053,027 to Manfredi, No. 5,263,947 to Kay, No. 5,370,637 to Braden, No. 5,830,932 to Kay, No. 6,342,049 to Nichols, No. 6,592,560 to Snyder and, No. 6,699,174 to Bennett. To date, female external incontinence devices have suffered from some or all of the disadvantages of not providing a functional position at anatomical rest such that excreted urine is directed away from the device, not effectively conforming to the parameatal surfaces in a position of anatomical rest such that excretal urine is directed away from the device, not providing an occlusive seal around the urethral meatus, not functionally managing urine output during use of the device in normal daily activities, requiring constant manual pressure to direct urine into a collection receptacle, being difficult to accurately place relative to the urethral meatus, requiring deployment by medical personnel, not being universal in nature relative to anatomical variations, failing to direct urine away from the body, requiring shaving and/or lateral distraction of the labia and thighs and/or utilizing firm or rigid structures or structures not matching the physical profile of the target anatomy with the wearer's body in normal positions, with labia, legs and thighs together in the midline.
The most problematic disadvantages of prior art female external incontinence devices is the discomfort associated with the relatively rigid or hard (high durometer) urine collection housings of the devices, particularly during normal daily activities, and the need for apparatus to press the housings against tissue surrounding the urethral meatus.
In one aspect of the present invention, a female external incontinence device includes a housing having a structure for adhesive attachment to tissue in the vaginal opening (introitus), in particular, the labia minora (labium minus), an intravaginal component extending from the flange at an angle to be inserted in the vagina to anchor the housing without occluding the vagina, a urine collection channel depending from the adhesive attachment structure and an outlet tube communicating with the urine collection channel, the adhesive attachment structure having an elongated opening therein to facilitate alignment of the housing with the urethral meatus regardless of where the urethral meatus presents while maintaining a parameatal seal around the urethral meatus.
In another aspect, a female external incontinence device includes a housing made of an elastomer forming, as a single part, a flange for attachment to tissue in the vaginal opening (introitus), in particular, the labia minora (labium minus), a intravaginal component extending from the flange at an angle to be inserted in the vagina, a urine collection channel depending from the flange and an outlet tube communicating with the urine collection channel, and an applicator having retainer and tray components disposed above and below the housing to sandwich the flange and the intravaginal component therebetween to facilitate deployment of the housing in the vaginal introitus.
A further aspect of the present invention is to provide a female external incontinence device including an elastomeric housing forming a flange, a urine collection channel communicating with an opening in the flange and an intravaginal component extending angularly from the flange to be received in the vagina, the housing having a shape that prevents buckling at a curved or angled portion between the flange and the intravaginal component when the housing is deformed thereby maintaining a parameatal seal around the urethral meatus.
Another aspect of the present invention is to improve comfort in a female external incontinence device by utilizing a housing made of an elastomeric material that is sufficiently soft and pliable to conform to tissue at the application site in normal positions of anatomical rest without causing injury or discomfort during wear while permitting urine flow therethrough.
In a further aspect, the present invention utilizes protuberances on the inner surfaces of walls of a housing of a female external incontinence device to permit flow of urine therethrough when the housing is collapsed along a midline in compliance to female anatomical structure such that the housing can be soft and pliant without occluding urine flow.
In another aspect of the present invention, the female external incontinence device is conformed to allow all the tissues of the introitus, fourchette, perineum and labia to return and remain in the normal “at rest” position with no distraction of the labia and with the labia minora flaccid with the medical aspect of the labia in direct approximation to each other and the thighs adducted to the midline or “closed” position of anatomical rest whether the wearer is seated, standing, lying supine, prone or walking.
A further aspect of the present invention is the conformation of a parameatal housing and a parameatal barrier body combined such that the central meatal opening of the barrier body can conform to the plane of the perineum and the plane of the anterior vaginal wall. The plane of the perineum and the plane of the anterior vaginal wall in female anatomy presenting in an at rest position meet at an angle generally ranging from 140° to 80°. The conformation of the parameatal barrier body and housing combine to provide a mating surface that is flexible and a parameatal opening that can flexibly mate with the perineum and the anterior vaginal wall throughout an angle varying from approximately 80° to 140° to optimize functionality of the female external incontinence device since the location of the urinary meatus in normal female anatomy can vary from the anterior, just below the clitoris, to the inner aspect of the vaginal verge, contiguous with the anterior vaginal wall.
Some of the features of the present invention providing advantageous use thereof include a urine collection chamber configured to enter the introitus and ensure collection of urine from the urethral meatus regardless of the position of the urethral meatus from just below the clitoris to within the introitus, a housing made of a soft, pliable, elastomeric material to be adhesively secured and worn in comfort to provide an occlusive parameatal urethral seal without requiring rigid or firm structures, alignment for proper placement or deployment of the external incontinence device facilitated even in those cases where the exact location of the urethral meatus cannot be visualized, a housing having midline collapsibility while permitting urine flow therethrough such that the anatomy does not remain distended during use, and a housing applied to the vaginal region in a manner to smooth out the rugae folds and creases of tissue to provide a smooth, relatively flat, sealing surface for receiving the parameatal barrier formed on the flange of the housing thereby optimizing a flat, wrinkle-free parameatal seal to produce effective, leak-free urine evacuation.
Other aspects and advantages of the present invention will become apparent from the following description of the exemplary embodiments taken in conjunction with the accompanying drawings, wherein like parts in each of the several figures are identified by the same reference characters.
As shown in
The inner wall surfaces 50 of the housing 22, particularly in the urine collection channel 28 and the outlet tube 46, have protuberances 52 extending inwardly therefrom to allow urine to pass through the urine collection channel 28 and outlet tube 46 when the housing 22 is collapsed along its midline in use. The protuberances 52 are shown as being semi-spherical or bead-like in
The intravaginal component 38 and the flange 24 have inner surfaces covered with an adhesive layer 58 as best shown in
The female external incontinence device 20 includes an applicator 60 as shown in
In use, female external incontinence device 20 is supplied with the housing 22 disposed in the applicator 60 as shown in
To position the housing 22 in the vaginal introitus, the grip portion of the applicator 60 is held in the hand, and the tongue deployment portion 86 of the applicator is inserted in the vagina as shown in
As shown in
As previously explained, the flange flexes toward the urine collection channel in the rest position. That is, the housing will collapse during use to have the position shown in
An example of a female external incontinence device constructed in accordance with the present invention follows. The housing 22 is made of a thin, soft, pliable, membranous elastomeric material. The housing membrane can have a thickness of from 0.002 to 0.009 inches and the protuberances can extend from the inner surfaces of the membrane along the urine collection channel and adjacent the flange and in the outlet tube to have a thickness, inclusive of the membrane, of 0.017 inches. The elastomeric material has a flexural modulus below 30,000 psi, elongation greater than 200%, a durometer at or below Shore A 30, a static coefficient of friction below 0.3 and a kinetic coefficient of friction below 0.1. Elastomeric materials that can be used to form the housing include polyurethane, nitrile and polyisoprine as well as embodiments of polyvinylchloride when the housing is injection molded. The housing is made as a membrane of the elastomeric material which is of minimal thickness. The intravaginal component can have a length from the point 34 to the end 40 of the pocket 42 of 5.0 cm, the urine collection channel can be offset downward 5.0 mm below the plane of the intravaginal component and can be 2.5 cm in height from the bottom to the top of the parameatal adhesion surface, i.e. the flange 24, the bulging formation 48 can bulge approximately 2.0 mm above and below the outlet tube surface and have any desired shape but the sides of the outlet tube exhibit no bulge around each side of the device, the width of the urine collection channel can be 5.0 mm throughout the channel until the channel meets the bulging formation, distal of the pivot bulge the outlet tube assumes a 9.0 mm inner diameter dimension, the flange/margin can be 7.0 mm from the edge of the urine collection channel opening 26 to the edge of the flange/margin on the top left and right sides as viewed from the distal end, the angle or curvature between the intravaginal component and the flange will complete a 105° curve to enter the introitus, the urine collection channel can terminate 1.0 cm past termination of the curved portion of the flange, the total length of the housing can be 11.5 cm. Of course, the dimensions can change to allow the female external incontinence device to be used by females not fitting into the 75% population.
Due to the design of the flange and the urine chamber opening, the housing will fit various sized vaginal vaults with varying urethral meatus presentations. The housing contact surface of the retainer component of the applicator is curved from lateral edge to lateral edge, as shown in
The applicator is used to ship, store and deploy the housing and can be formed from a plastic such as polystyrene, polyvinylchloride or polypropylene with the plastic slick to the touch and having “self-lubricating” characteristics for vaginal insertion in a manner similar to plastic tampon applicators. The plastic allows the elastomeric material of the housing to slide easily across the applicator surface to aid withdrawal of the applicator once the housing is in confirmation with the anatomy. The applicator essentially forms a sandwich of two plastic components to hold the thin, soft, highly flexible and pliable housing in position therebetween from manufacture to deployment. The retainer component of the applicator holds the housing in conformation with the tray component of the applicator and provides a means for removing the release film which can be attached at the tab by an adhesive bead. For optimal effectiveness, the release film is removed in a manner so that the most proximal portion of the adhesive surface 58 is the first portion of the adhesive surface to be exposed to the application surfaces. The retainer component also holds the housing in conformation with the tray component of the applicator by lightly snapping thereto via the clips 72, 74, 78 and 80 to hold the housing in proper position for shipping and deployment. The release film removal is accomplished by pulling the retainer component of the applicator away from the tray component by grasping the tab and pulling the release film away from the housing with the clips deforming to allow detachment of the retainer component from the tray component. The release film can be a type of silconized polyurethane film similar to the Argotec urethane film 27303. The tray component of the applicator acts as a support channel for the housing and provides an insertion function due to the insertion end being received in the intravaginal component pocket, it being noted that intravaginal component 38 is flaccid and flexible due to its membranous nature and that the intravaginal component deployment portion imparts rigidity to facilitate deployment of the intravaginal component against the anterior vaginal wall and then proceeding in a contiguous moving front of application to the intralabial portion proximal the parameatal surface. When the applicator is removed, the thin soft, flexible, pliable nature of the entire housing provides protection of the application site from crush injury, pressure injury and/or ischemia. The applicator facilitates adhesion through equal application of force during deployment and withdrawal.
As shown in
A modification 20″ of the female external incontinence device of the present invention is shown in
As shown in
The tray component 64′ has a grip portion 84′ with a bottom, scalloped, finger grip surface 104 and an upper surface 106 for supporting urine collection channel 28, bulging formation 48 and outlet tube 46. The release film 59′ is folded on itself to have a U-shape with a free end 108 extending along the grip portion 84′ of tray component 64′, a length 110 extending along the outer side of the intravaginal component 38 and the flange 24 after passing through a slot-like opening 112 in a distal end 85′ of intravaginal component deployment portion 86′, and the release film 59 is folded on itself at 114 adjacent the anterior end of the flange-supporting, recess-containing member 88 to form a length 116 leading to a secured end 118 at the distal end 85′ adjacent opening 112. Accordingly, the release film is folded on itself at opening 112 and at fold 114 to have a U-shape. The length 116 of the release film covers the layer of adhesive 58 on intravaginal component 38 and flange 24 prior to deployment of the female external incontinence device on the body.
As shown in
Another modification is shown in
In accordance with a method of use of the female external incontinence device 20 according to the present invention, a patient is in a lithotomy position or recumbent on her back, in gynecologic stirrups with her knees flexed, her thighs abducted and her feet flat on the bed in the area of the buttocks. In the first step, the applicator is initially inserted with the split or space between the retainer component and the tray component parallel to the split between the labia. Initial insertion of the applicator will spread the labia. The applicator is then rotated 90° to bring the retainer component in contact with the anterior vaginal wall in such a way as to spread the rugae that are found present in the introitus. The rugae run in a horizontal, somewhat circumferential plane about the anterior vaginal wall, and the retainer component is pressed up and forward as it is delivered into the introitus in order to spread the rugae to flatten them. The tray component is held by the grip portion with a modest amount of upward and forward pressure to keep the rugae spread and flattened while the retainer component and/or the release film is removed to expose the adhesive to a largely flat and wrinkle-free surface which, when allowed to go to rest, will let the rugae return. Once the adhesive is exposed by removing the release film to expose the adhesive with a hand supporting the housing so the housing is not inadvertently withdrawn, the tray component is withdrawn without rotation and taking care not to dislodge the housing.
The use of an elastomeric material to form the housing in cooperation with an elastic layer of adhesive, (e.g. hydrocolloid) provides elastic compression and permits comfortable use of the female external incontinence device while also providing an effective seal around the urethral meatus. The unitary formation of the housing and the intravaginal component of a soft, pliable, membranous, elastomeric material provides the advantages of ease of manufacture and positioning on the body as well as comfort in use; however, the intravaginal component can take other forms, such as a pessary or balloon structure, coupled with the housing.
Inasmuch as the present invention is subject to many variations, modifications and changes in detail, it is intended that all subject matter discussed above or shown in the accompanying drawings be interpreted as illustrative only and not be taken in a limiting sense.