The present invention is generally related to implantable systems for the treatment of erectile dysfunction in men. More specifically, the present invention is directed to an implantable system that uses the existing circulatory system to create and maintain an erection in a patient.
Erectile dysfunction (“ED”) is believed to affect more than ninety million men in the United States and Europe, with seventeen million presenting with severe conditions that greatly interfere with the ability to initiate and maintain erections. ED may arise from a number of causes. Age brings on a lack of arterial elasticity in vessels supplying blood to erectile tissues. Damage to nerves necessary for initiating and sustaining erections brought on by chronic conditions (such as diabetes) or by injury can lead to dysfunction. A significant cause of nerve damage comes from injury that occurs during prostate surgeries, especially radical prostatectomies. Although new surgical procedures have been introduced that conserve the nerves in this region, a majority of men who undergo such procedures can still expect some degree of post-operative ED.
A number of oral medications for treating ED have entered the marketplace in recent years, including VIAGRA, CIALIS and LEVITRA. These medications all provide significant relief to a large segment of men with ED. However, they each require that the medication be taken in advance of initiation of sexual activity and their effects may be delayed if ingested with food. Furthermore, the effectiveness of such drugs can vary greatly from patient to patient, and is even ineffective in a large cross-section of patients.
Various treatments have also been tried in connection with ED, including a muscle constrictors or relaxers, such as Prostaglandin E1, administered by injection into the corpus cavernosum of the penis, positioning a suppository within the urethra and/or topically. These approaches allow for less advance preparation, but are neither consistently effective nor desirable applications across patient populations, especially radical prostatectomy patients.
Implantable devices are also often used to address ED, especially when medications are ineffective or contraindicated. Typically, the implantable devices, such as implantable penile prosthetics, comprise at least one collapsible support that deploys to create an erection and retracts to conceal the support(s). However, these devices are often fully implanted within the patient's body, typically with a substantial portion of the device being implanted within the corpus cavernosum. As a result, the surgical procedure is often highly invasive often requiring positioning of multiple components throughout the pelvic region and reproductive organ. In addition, the implantation procedure can require a large incision and/or placement of temporary tubing to maintain the urology and reproductive functions of the penis following implantation and healing. Patients can become discouraged from pursuing this form of treatment by the extensive nature of the surgery. In addition, penile implants are an end stage treatment, and it is often desirable to provide treatment earlier in the disease state. Thus, there is a desire to obtain a minimally invasive yet effective and durable solution to treat ED that can be used with minimal to no side effects.
The present invention is directed to treating ED by placing a constrictive cuff around at least one of the veins leaving one or both of corpus cavernosum of the penis. The constrictive cuff can be selectively tightened around the vein to reduce the inner diameter of the vein to create a back pressure within the corpus cavernosum to maintain the erection. The implantation of the cuff is minimally invasive and maintains the natural circulatory system of reproductive system. Unlike implantable devices where a support is positioned within the corpus cavernosum, the cuff assists in the normal operation of the penis without disrupting the urological or reproductive function of the penis. Similarly, in one aspect, the cuff is sized to maintain the flow of blood through the vein while creating the back pressure within the corpus cavernosum. The flow through the vein is maintained to prevent over pressuring of the corpus cavernosum.
An implantable system for treating ED, according to an aspect of the present invention, comprises a constrictive cuff and an inflation system for controlling the tightening of the constrictive cuff. The constrictive cuff can further comprise a supportive backing and at least one inflatable chamber. In one aspect, the supportive backing can be positioned around the vein such that the inflatable chambers are positioned against the vein. The supportive back can be inelastic such that inflating the chambers tightens the chambers against the vein and reduces the effective inner diameter of the vein to create back pressure within the corpus cavernosum. Similarly, deflating the chambers allows the vein to re-expand and allow normal flow of the blood through the vein. In one aspect, the inflatable chamber or chambers can be sized and spaced along the backing such that inflation of the chambers presses the chambers against all sides of the vein to prevent crimping of the vein wall. In one aspect, the chamber or chambers can be shaped to bend the walls of the vein such that the inner diameter of the vein narrows to at least one choke point when the chambers are inflated. Alternatively, the chambers can be shaped to compress the walls evenly to maintain an constant inner diameter through the cuff.
In one aspect, the supportive backing can comprise a flexible strap that can be wrapped around the vein. Alternatively, the supportive backing can comprise at least one rigid panel having a hinge portion for positioning the rigid panel to follow the contour of the wall of the vein. In either configuration, the supportive backing is non-elastic such that the inflation of the chamber or chambers does not cause the supportive backing to stretch and instead forces the chamber or chambers to expand against the walls of the vein to compress the vein.
In one aspect, the chamber can comprise at least one predefined fold line defining a hinge portion for bending or folding the chamber to position the chamber around the vein. In this configuration, the chamber can be folded along the fold lines to define a plurality of faces, which contact the rounded wall of the vein to apply pressure to the vein to reduce the inner diameter of the vein. In another aspect, the chamber can further comprise a plurality of grooves that define a plurality of creases to define a continuous surface for contacting the wall of the vein. Similarly, each chamber can comprise at least one expansion groove positioned at the edges of the chamber or chambers. The expansion groove allow the chamber to expand when inflated to press against the vein and fold tightly against the supportive backing when the chamber is deflated to allow the vein to fully expand.
A method for treating ED, according to an aspect of the present invention, comprises positioning a cuff around at least one vein exiting from the corpus cavernosum, wherein the cuff comprises at least one inflatable chamber positioned against a wall of the vein. The method further comprises positioning a supportive cuff around the exterior of each chamber to prevent outward expansion of the chamber during inflation. The method also comprises inflating each chamber to apply pressure to the wall of the vein to decrease the inner diameter of the vein so as to create back pressure within the corpus cavernosum to inflate and maintain the corpus cavernosum at a predetermined pressure. The method also comprises deflating each chamber to remove the pressure on the wall of the vein to allow the inner diameter of the vein to return to the normal size and lower the pressure of the blood within the corpus cavernosum.
The above summary of the invention is not intended to describe each illustrated embodiment or every implementation of the present invention. The Figures and the Detailed Description that follow more particularly exemplify these embodiments.
The invention can be more completely understood in consideration of the following detailed description of various embodiments of the invention in connection with the accompanying drawings, in which:
While the invention is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the invention to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
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A method for treating ED according to an aspect of the present invention comprises positioning the cuff 42 having the at least one inflatable chamber 48 around the vein 30 such that the inflatable chamber 48 is positioned against the vein 30. The method further comprises inflating each inflatable cylinder 48 to constrict the vein 30 creating back pressure within the corpus cavernosum 26. Finally, the method comprises deflating each chamber 48 such that the vein 30 returns to its original diameter.
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In one aspect, the cuff 42 can further comprise actuation devices, automated sensors and like devices to control the restriction level and timing of the cuff 42. The relative constriction of the vein 30 controls the pressure within the corpus cavernosum 26. The constriction of the cuff 42 can be adjusted such that the relative pressure within the corpus cavernosum 26 can be increased or decreased depending on the patient's preference. Similarly, the constriction of the cuff 42 can be adjusted to adapt the operation of the cuff 42 for each patient's unique physiology allowing for consistent performance across multiple patients.
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A variety of materials may be used to form portions or components of the present invention, including nitinol, polymers, elastomers, thermoplastic elastomers, metals, ceramics, springs, wires, plastic tubing, and the like.
All patents, patent applications, and publications cited herein are hereby incorporated by reference in their entirety as if individually incorporated, and include those references incorporated within the identified patents, patent applications and publications. Obviously, numerous modifications and variations of the present invention are possible in light of the teachings herein. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced other than as specifically described herein.
The present application claims the benefit of U.S. Provisional Application Ser. No. 61/423,795, filed Dec. 16, 2010, and entitled “SYSTEM AND METHOD FOR TREATING ERECTILE DYSFUNCTION” which is incorporated herein in its entirety by reference.
Number | Date | Country | |
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61423795 | Dec 2010 | US |