The present disclosure relates generally to the field of urological medical devices and methods and, more specifically, to devices and methods for training and controlling the bladder of a subject.
Overactive Bladder (OAB) is a common condition that affects as many as 1 in 3 adults over the age of 40. OAB is the result of the bladder contracting at a higher than normal rate, even during periods of lower volumes of urine in the bladder. Common symptoms include incontinence and urgency and frequency of urination, impairing quality of life of those affected.
Current methods of OAB therapy include behavioral modifications (e.g., decreasing fluid intake, timed voiding, avoiding bladder irritates), pelvic floor therapy (e.g., pelvic muscle exercises, tibial nerve simulators), medications that block receptors to the bladder, intravesical treatments, and surgery (e.g., bladder augmentation, diversion). However, the current methods of OAB therapy have various disadvantages or shortcomings. For example, behavioral modifications, pelvic floor therapy, and medications often have poor compliance. Over 50% of patients stop taking oral therapies within several months of starting such therapy. Further, pelvic floor muscle training is often recommended but is not directed to the bladder nor can it aid with training the bladder.
Therefore, devices and methods are needed to enable a patient's bladder to allow larger volumes of urine at any given pressure. There also exists a need for such devices and methods to be non-invasive, discreetly wearable, and user-friendly, allowing patients more compliance with therapy and control over their OAB symptoms throughout the day.
Devices, methods, and systems for controlling a bladder of a subject are disclosed. For example, an apparatus for controlling the bladder can comprise a garment or accessory configured to be worn at least partially around a lower truncal region of a subject and a compression device coupled to the garment or accessory. The compression device can be coupled to the garment or accessory. The compression device can be configured to pressurize an abdominal wall of the subject when the garment or accessory is worn by the subject.
The garment can be a pair of compression shorts or the like. The accessory can be a belt or the like. The garment can also be a pair of compression shorts comprising a belt.
The compression device can comprise a device housing. The device housing can comprise a contact surface. The compression device can also comprise a device base. The compression device can also comprise a threaded shaft. The threaded shaft can couple the device base to the device housing. The compression device can also comprise an actuator. The actuator can be configured to translate the device housing in relation to the device base in a medial or lateral direction relative to the subject such that the contact surface of the device housing applies compressive forces to the abdominal wall of the subject when translated. The compression device can also comprise a portable power supply (e.g., a battery) configured to power the actuator.
The actuator can comprise a shape memory actuator. The shape memory actuator can be configured to translate the device housing in relation to the device base in response to a temperature change. The bladder control apparatus can further comprise a heating element. The heating element can be configured to apply heat to the shape memory actuator to change a shape of the shape memory actuator. The shape memory actuator can comprise one or more shape memory flaps. The shape memory flaps can be configured to translate the device housing in relation to the device base in response to the temperature change. The shape memory actuator can also comprise one or more shape memory springs. The shape memory springs can be configured to translate the device housing in relation to the device base in response to a temperature change. The one or more shape memory springs can be configured to change the shape of a deformable sheet. The deformable sheet can make up part of the device housing. The shape memory actuator can be made in part of at least one of a shape memory alloy and a shape memory polymer.
The actuator can further comprise a threaded shaft (e.g., leadscrew or part of a worm gear). The threaded shaft can couple the device base to the device housing. The actuator can also comprise a rotary gear. The rotary gear can be configured to rotate the threaded shaft to translate the device housing in relation to the device base. The compression device can further comprise a heating element. The heating element can be configured to apply heat to the abdominal wall of the subject.
The compression device can also be configured to be in wireless communication with a remote device. The compression device can be configured to apply compressive forces to the abdominal wall of the subject automatically in response to a user input applied to the remote device. The user input can be a manipulation of a sensation meter graphic. The sensation meter graphic can be shown on a display of the remote device. The compression device can further comprise an ultrasound unit comprising an ultrasound probe. The ultrasound unit can be configured to detect a volume within the bladder of the subject. The compression device can be communicatively coupled to the ultrasound unit. The compression device can be configured to automatically apply compressive forces to the abdominal wall of the subject in response to the volume detected by the ultrasound unit.
The contact surface of the device housing can be substantially planar.
The apparatus can further comprise a fluid-filled covering. The fluid-filled covering can be configured to cover at least part of the device housing. The fluid-filled covering can be configured to conform to an anatomy of the subject. The fluid-filled covering can be filled with air or another type of gas. The fluid-filled covering can also be filled with a liquid. The fluid-filled covering can also be filled with particulates. In this variation, the fluid-filled covering can also apply force(s) to the abdominal wall via a pump (e.g., a fluid pump, a pneumatic based pump, or the like).
One variation of a method of controlling a bladder of the subject can comprise securing a compression device to the subject. The compression device can be secured to the subject using a garment or accessory. The garment or accessory can be configured to be worn at least partially around a lower truncal region of a subject. The apparatus can comprise a compression device. The compression device can be coupled to the garment or accessory. The compression device can be configured to pressurize an abdominal wall of the subject when the garment or accessory is worn by the subject.
The compression device can comprise a device housing. The device housing can comprise a contact surface. The compression device can also comprise a device base. The compression device can also comprise a threaded shaft (e.g., leadscrew or part of a worm gear). The threaded shaft can couple the device base to the device housing. The compression device can comprise an actuator. The actuator can be configured to translate the device housing in relation to the device base in a medial or lateral direction relative to the subject such that the contact surface of the device housing applies compressive forces to the abdominal wall of the subject when translated. The compression device can further comprise a portable power supply (e.g., a battery) configured to power the actuator. The method can comprise translating the device housing in relation to the device base such that the contact surface of the device housing applies compressive forces to the abdominal wall of the subject when translated.
Also disclosed is a bladder control system. The bladder control system for controlling the bladder can comprise a garment or accessory. The garment or accessory can be configured to be worn at least partially around a lower truncal region of a subject. The system can further comprise a compression device. The compression device can be coupled to the garment or accessory. The compression device can be configured to pressurize an abdominal wall of the subject when the garment or accessory is worn by the subject.
The compression device can comprise a device housing. The device housing can comprise a contact surface. The compression device can also comprise a device base. The compression device can further comprise a threaded shaft. The threaded shaft can couple the device base to the device housing. The compression device can further comprise an actuator. The actuator can be configured to translate the device housing in relation to the device base in a medial or lateral direction relative to the subject such that the contact surface of the device housing applies compressive forces to the abdominal wall of the subject when translated. The compression device can also comprise a portable power supply (e.g., a battery) configured to power the actuator. The system can further comprise a remote device in wireless communication with the compression device. The remote device can be configured to provide feedback to the compression device in response to a characteristic of the bladder of the subject.
The device base 102 and the device housing 104 can be connected via the threaded shaft 106 and can be substantially parallel to each other. In the first configuration, the device housing 104 can be positioned in a resting configuration, as seen in
The compressive forces can induce stress softening (strain softening) and thus result in improved dynamic elasticity within the bladder of the subject. Since symptoms of frequency and urgency of urination occur at lower volumes within the bladder, strain via external compression can train the detrusor muscle within the bladder. This training can regulate bladder elasticity and thus can effectively increase the bladder's ability to hold more volume at any given pressure.
The threaded shaft 106 can be attached to the device base and fit into a recess of the device housing 104. The threaded shaft 106 can couple the device base 102 to the device housing 104 and can be configured to allow the device housing 104 to move in relation to the device base 102 in order to compress the abdominal wall of a subject. Alternatively, the threaded shaft 106 can be attached to the device housing 104 and fit into a recess of the device base 102. The threaded shaft 106 can be a lead screw, a worm gear, or any other suitable mechanisms for translating the device housing 104 with respect to the device base 102. A variation with a lead screw can have a motor and drive pulley coupled to the motor and configured to power the rotation of the lead screw. A variation with a worm gear can comprise a worm wheel and a worm barrel configured to rotate with respect to the device housing 104.
Additionally, the compression device 100 can comprise a stepper motor (not shown) configured to rotate the threaded shaft 106 to oscillate the device housing 104 in relation to the device base 102. The stepper motor can be attached directly to a rotary gear, adding durability to the device 100. The stepper motor can be placed within the threaded shaft 106, within the device base 102 or device housing 104, or another location within the device 100. The stepper motor can be sized to achieve precise positioning and control the translational speed of the device housing 104 by controlling the rotation of the threaded shaft 106. The stepper motor can divide a full rotation into an equal number of loops, allowing a motor controller to command the rate and magnitude of the compressive forces placed on the abdominal wall. In one example, the stepper motor can be a high-torque NEMA 23 or NEMA 24 bipolar stepper motor having a step angle of approximately 1.8 degrees and a holding torque of between about 2.40 Newton-meter (N-m) and 3.5 N-m.
To perform designed bladder compressions, the rotary gear and the stepper motor can be activated to rotate the threaded shaft 106 to translate the device housing 104 in relation to the device base 102. Oscillations and compression forces can be customized according to different subject needs. For example, a magnitude or a rate of compression can be adjusted or set by the subject or another user. The device housing 104 can also rotate clockwise or counterclockwise in relation to the subject's abdominal wall. Such control may be executed via an attached or remote device 800 (see
The device housing 104 and the device base 102 can comprise one or more nodular posts 110 located on outer surfaces of the device housing 104 and the device base 102. The nodular posts 110 can be circular protrusions, though it should be considered that various protrusions shapes can be considered.
The base and the housing can be coupled. One method of coupling can include the use of elastic bands 116 (e.g., rubber bands or other types of elastic bands) can loop around the nodular posts 110 to couple the device housing 104 to the device base 102 while the device base 102 is being moved in relation to the device housing 104. This can ensure that the device housing 104 and the device base 102 stay connected to each other in the first and second configurations, helping maintain discretion for the subject during daily activities. This can also help allow the user to maintain continuous exercise throughout the day, whether such exercise is for bladder therapy or otherwise.
The compression device 100 can also comprise an actuator. The actuator can further comprise a threaded shaft 106 that can couple the device base 102 to the device housing 104. The actuator can be configured to translate the device housing 104 in relation to the device base 102 in a medial or lateral direction relative to the subject such that the contact surface 112 of the device housing 104 applies compressive forces to the abdominal wall of the subject when translated. The compression device 100 can also comprise a portable power supply configured to supply power to the actuator.
The compression device 100 can further comprise a heating element 306. The heating element 306 can be provided within the compression device 100 to change the shape of the shape memory actuator, such as the shape-memory flaps 302. The heating element 306 can be connected to an external power source (not shown) via wires 308. The wires 308 can run through the hem of the garment or alongside the garment and secured in place to prevent the wire from twisting or coiling. The shape memory flaps 302 can be configured to translate the device housing 104 in relation to the device base 102 in response to the temperature change.
The temperature of the shape-memory flaps 302 can be altered using mechanisms of conduction and convection via the heating element 306. Conduction and convection can occur individually or in combination to achieve a desired temperature to produce a desired conformation of the shape-memory flaps 302. Heating and cooling by conduction can also allow for body heat to conduct from the body of the subject into the shape-memory flaps 302. Additionally, cooling by conduction can involve allowing heat to conduct out of the shape-memory flaps 302 into other surrounding parts of the compression device 100. As such, the shape-memory flaps 302 and other surrounding parts can be in contact with thermally conductive material to exhaust heat. Parts can also be affected by cooler air or surface external to the device to exhaust heat. Heating and cooling by convection can involve allowing warm and cool fluid, respectively, to pass over the shape-memory flaps 302. The cooling fluid can also be air or other fluids such as water.
After activation, the shape-memory flaps 302 change shape to project in a direction towards the device housing 104. This shape change can directly apply force and pressure onto the abdominal wall of the subject, compressing the abdominal wall. The shape-memory flaps 302 can act as a lever in this manner, producing force onto the abdominal wall. If desired, the shape-memory flaps 302 can be configured to deliver a varying level of force by varying the temperature applied thereto. Alternatively, an intermediary component such as a spring or pressure reservoir can be used to divert or store a portion of the force generated by the shape-memory flaps 302. The shape memory actuator can also be in the form of any mechanical structure that generates force. Further, the shape memory actuator can be configured so that contraction of the shape-memory actuator provides force to the abdominal wall.
The shape memory actuator can also comprise a spring actuator 400 comprised as one or more shape memory springs 402. Like the shape-memory flaps 302, the shape memory springs 402 can be configured to translate the device housing 104 in relation to the device base in response to a temperature change.
The actuator can also comprise another type of shape memory actuator 500 (see, e.g.,
The shape memory actuator 500 can be configured to translate the device housing in relation to the device base in response to a temperature change. The shape memory actuator can comprise one or more shape memory flaps.
The heating element 306 within the compression device 100 can also deliver heat directly to the abdominal wall over the bladder. Heat can be delivered to the abdomen either separately or concurrently with force from device housing 104. The heating element 306 can be placed within the threaded shaft 106, within the device base 102, within the device housing 104, or another location within the compression device 100. In such configurations, the compression device 100 can have a thermal insulator to protect the subject 118. The thermal insulator can bring the compression device 100 to a suitable temperature for contact with the subject.
The compression device 100 can further comprise a fluid-filled covering. This mechanism can further assist in heating or cooling a shape-memory alloy, for example. Such a covering can alternatively be used as a membrane to protect the abdominal wall from overheating. As such, the fluid-filled covering can be configured to cover at least part of the device housing and can be configured to conform to an anatomy of the subject. Additionally, the fluid-filled covering can be filled with an air, a gas, or a liquid. Alternatively, the fluid-filled covering can also be filled with particulates.
An inflatable membrane can be provided with the compression device 100 to cover the compression device 100 and fit the anatomy of the subject. The inflatable membrane can be in the form of a drape, a pouch, or an inflatable wrap. The subject can manually inflate or deflate the inflatable membrane as desired. The inflatable membrane can either be attached to the compression device 100 or can be separate to the device 100 for the subject to attach themselves as desired.
An inflatable membrane can also serve as an independent method to apply compressive force to the abdomen through manual or automated inflation with or without an underlying base and may be secured to the belt or garment directly.
The compression device 100 can also comprise a vibration motor that applies vibration perpendicular to the abdominal wall overlying the bladder. Vibration can occur simultaneously with external compression or independently to the external compression.
For example,
As previously discussed, a user can apply a user input to one of the graphical user interfaces to control the compression device 100. For example, a user can apply a user input (e.g., a touch input) to a sensation meter graphic (e.g., by sliding or otherwise manipulating the sensation meter graphic). The sensation meter graphic can be shown on a display of the remote device 800.
For example,
The user interface in
Once the exercises have started to operate, the user can view certain statistics on the doctor dashboard 802, as seen in
The remote device can be configured to provide feedback to the compression device in response to a characteristic of the bladder of the subject. Thus, the compression device 100 can not only exercise the detrusor muscle in the manner as described above, but it can also monitor the bladder environment and the biomechanics of the bladder (e.g., micromotion of the bladder wall, wall tension, bladder volume, etc.). Furthermore, these various forms of feedback can directly control the device and its ability to activate or deactivate.
From this point on, the system can automatically operate, as seen in
During this process, the ultrasound probe can be constantly gathering data regarding the volume, shape, or motion within the bladder. The ultrasound probe can be configured to provide an input to the remote device 800, leading to information regarding the sensation levels of the subject. This capturing of sensation levels can occur automatically and continues the automatic feedback loop such that the user does not need to manually input until they desire to. The compressions can also adjust according to previous cycles of compressions. With all of these components, compression device 100 can employ cross-sectional analysis to determine elastic properties of the bladder and combine this information with bladder volume or shape change for optimally timed and designed bladder compressions.
The compression device 100 can further comprise an ultrasound unit 1202 comprising an ultrasound probe. The ultrasound unit can be configured to detect a volume within the bladder of the subject. The compression device 100 can be communicatively coupled to the ultrasound unit. The compression device 100 can be configured to automatically apply compressive forces to the abdominal wall of the subject in response to the volume detected by the ultrasound unit 1202.
The ultrasound probe 1200 can be held within the belt 114, though it should be understood that the ultrasound probe 1200 can be incorporated into the compression device 100 itself or configured as a standalone element. Additionally, ultrasound sensors can also be built into the belt 114 (e.g., along a length of the belt 114). The ultrasound probe 1200 can be positioned in such a manner such that ultrasound sensors within the probe can have proper contact with the bladder of the subject. The ultrasound probe 1200 can be configured as a non-invasive sensor and can constantly monitor the bladder 504 of the subject. Alternatively, the ultrasound probe 1200 can be secured directly to the subject via medical tape or other suitable attachment mechanisms.
An ultrasound unit 1202 can be embedded into the battery 602 as seen in
As seen in
Each of the individual variations or embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other variations or embodiments. Modifications may be made to adapt a particular situation, material, composition of matter, process, process act(s) or step(s) to the objective(s), spirit or scope of the present disclosure.
Methods recited herein may be carried out in any order of the recited events that is logically possible, as well as the recited order of events. Moreover, additional steps or operations may be provided or steps or operations may be eliminated to achieve the desired result.
Furthermore, where a range of values is provided, every intervening value between the upper and lower limit of that range and any other stated or intervening value in that stated range is encompassed within the disclosure. Also, any optional feature of the inventive variations described may be set forth and claimed independently, or in combination with any one or more of the features described herein. For example, a description of a range from 1 to 5 should be considered to have disclosed subranges such as from 1 to 3, from 1 to 4, from 2 to 4, from 2 to 5, from 3 to 5, etc. as well as individual numbers within that range, for example 1.5, 2.5, etc. and any whole or partial increments there between.
All existing subject matter mentioned herein (e.g., publications, patents, patent applications) is incorporated by reference herein in its entirety except insofar as the subject matter may conflict with that of the present disclosure (in which case what is present herein shall prevail). The referenced items are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present disclosure is not entitled to antedate such material by virtue of prior disclosure(s).
Reference to a singular item, includes the possibility that there are plural of the same items present. More specifically, as used herein and in the appended claims, the singular forms “a,” “an,” “said” and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art.
In understanding the scope of the present disclosure, the term “comprising” and its derivatives, as used herein, are intended to be open-ended terms that specify the presence of the stated features, elements, components, groups, integers, and/or steps, but do not exclude the presence of other unstated features, elements, components, groups, integers and/or steps. The foregoing also applies to words having similar meanings such as the terms, “including”, “having” and their derivatives. Also, the terms “part,” “section,” “portion,” “member” “element,” or “component” when used in the singular can have the dual meaning of a single part or a plurality of parts. As used herein, the following directional terms “forward, rearward, above, downward, vertical, horizontal, below, transverse, laterally, and vertically” as well as any other similar directional terms refer to those positions of a device or piece of equipment or those directions of the device or piece of equipment being translated or moved. Finally, terms of degree such as “substantially”, “about” and “approximately” as used herein mean a reasonable amount of deviation (e.g., a deviation of up to ±0.1%, ±1%, ±5%, or ±10%, as such variations are appropriate) from the specified value such that the end result is not significantly or materially changed.
This disclosure is not intended to be limited to the scope of the particular forms set forth, but is intended to cover alternatives, modifications, and equivalents of the variations or embodiments described herein. Further, the scope of the disclosure fully encompasses other variations or embodiments that may become obvious to those skilled in the art in view of this disclosure.
This application is a continuation of International Patent Application No. PCT/US2021/016459 filed on Feb. 3, 2021, which claims the benefit of priority of U.S. Provisional Application No. 62/969,210 filed on Feb. 3, 2020, the contents of which are incorporated herein by reference in their entities.
Number | Date | Country | |
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62969210 | Feb 2020 | US |
Number | Date | Country | |
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Parent | PCT/US2021/016459 | Feb 2021 | US |
Child | 17817071 | US |