Prosthesis for improved penile functionThe present patent application is a divisional application of the chinese invention patent application No.201680008012.6 (international application number PCT/US2016/020881) entitled "prosthesis for improved penile function" filed 3/4/2016.
Technical Field
The present invention relates generally to surgical prostheses for enhancing the appearance and operation of organs, and more particularly to penile prostheses capable of restoring impaired or poorly performing penile function to satisfactory sexual function.
Background
Prostheses for implantation in the penis to provide rigidity and improve size are known in the art. Such a prosthesis may include an elongated malleable stem portion that is received within a generally tubular body of physiologically inert plastic. The malleable stem portion enables the prosthesis to be adapted to various shapes by bending or twisting. During intercourse, the prosthesis will maintain the penis in an erect condition, after which the penis can be positioned and maintained in a more convenient and comfortable position. Finney, us patent document No.4,204,530 describes a prosthesis having a sleeve for increasing the diameter of the penis, and the prosthesis comprises a flexible sheet of soft, physiologically acceptable material having a length sufficient to extend from the glans penis to the base of the penis when formed in the general shape of a cylindrical sleeve, and having a width insufficient to completely encircle the penis but sufficient to cover the corpora cavernosa. The improved rod-like penile prosthesis may have a proximal portion for positioning within the corpus cavernosum adjacent the pubic bone to support the prosthesis, a distal portion for positioning within the corpus cavernosum of the prolapsed penis, and a hinge separating the distal and proximal portions. Masters, U.S. patent No.4,669,456, describes a penile prosthesis that includes an elastomeric rod and a coil of wire coaxially embedded within at least a portion of the rod. Subrini, U.S. patent No.6,015,380, describes a prosthesis that can be used to increase penile volume. Moreira de Azeredo, WO 86/01398 describes a penile rigid prosthesis for the treatment of male erectile dysfunction, the penile rigid prosthesis comprising at least one penile prosthesis comprising an elongated malleable barrel adapted to be surgically placed in the corpus cavernosum.
The prior art teaches the use of subcutaneously placed prostheses to stiffen the penis, but does not teach the use of some profiles which provide structural advantages, nor does it teach means for restricting flow through the dorsal vein, nor does it teach means for preventing axial movement or slippage of the prosthesis relative to the long axis of the penis. The present invention fulfills these needs and provides further related advantages as described in the following summary.
Disclosure of Invention
The present invention teaches certain benefits in construction and use which result in the following objectives. The penile prosthesis may have a cylindrical elongated body providing a wall thickness that varies circumferentially from a maximum thickness at a top surface thereof to a minimum thickness along a bottom surface thereof. The wall thickness may also vary longitudinally from a maximum thickness at the proximal end of the device to a minimum thickness at the distal end. The device is preferably made of silicone rubber and has a length and size to enable subcutaneous implantation around the corpus cavernosum, the device providing sufficient rigidity to enable intercourse while still maintaining sufficient flexibility to facilitate positioning when the penis is flaccid.
The described and claimed prosthesis has the object of providing a rigidity that reaches the penis of a person in order to enable intercourse.
Another object is to provide a suitably tapered appearance.
Yet another object is to enable surgical implantation without removal of existing organ portions or associated tissue.
Yet another object is to prevent axial movement of the prosthesis after implantation.
Another object is to provide an instrument for anchoring the distal end of a prosthesis.
An important objective is to prevent blood flow out of the penis during intercourse.
According to one aspect of the present invention, there is provided a penile prosthesis comprising: a barrel for subcutaneous implantation into a penis; the barrel-shaped body has two hingeable halves, which can meet and separate from each other according to the erect state of the penis; and a mesh extending between the two halves.
Preferably, the penile prosthesis further comprises a gauze sleeve sewn to an end of the barrel at a position enabling the barrel to be sewn to the corpus cavernosum of the penis.
Preferably, the mesh extends over at least one of an outer surface and an inner surface of the hingeable half.
Preferably, there are two meshes, one mesh extending over the inner surface and one mesh extending over the outer surface.
Preferably, the mesh is embedded at or adjacent to at least one of the inner and outer surfaces of the cylindrical body.
Optionally, there are two meshes, one mesh being embedded at or adjacent to the inner surface and one mesh being embedded at or adjacent to the outer surface.
Preferably, the mesh comprises silicon.
Preferably, the mesh is positioned relative to the halves to anchor a prosthesis to at least one of the Buckner's fascia or the albuginea of the penis with sutures.
Preferably, the two hingeably joined halves are formed separately.
Preferably, the barrel-shaped body is formed as a single integral part having a length extending over at least a part of the length of the penis.
Preferably, said cylindrical body has a wall thickness that varies circumferentially from a maximum thickness to a minimum thickness.
Optionally, the cylindrical body has a wall thickness that varies longitudinally from a maximum thickness to a minimum thickness.
Preferably, the cylindrical body has two opposite longitudinal edges defining a longitudinal gap in the cylindrical body.
Preferably, the cylindrical body defines an oblate space therein.
Preferably, the penile prosthesis further comprises a compression rib engaged to the barrel between the articulatable halves, the compression rib positioned to compress against a deep dorsal vein of the penis when the penis is erect, thereby delaying vascular blood flow in the deep dorsal vein.
Preferably, the press rib engages with the mesh.
Preferably, the hingeable halves are asymmetric.
Preferably, the mesh acts as a hinge between the two halves.
According to another aspect of the present invention, there is provided a penile prosthesis comprising: a barrel for subcutaneous implantation into a penis; and a mesh at or adjacent at least a portion of the outer or inner surface of the cylindrical body.
According to yet another aspect of the present invention, there is provided a penile prosthesis comprising: a barrel for subcutaneous implantation into a penis; and wherein the cylindrical body has a wall thickness that varies longitudinally from a maximum thickness to a minimum thickness.
Other features and advantages of the present invention will become apparent from the following more detailed description, taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the invention.
Drawings
The figures illustrate the invention. In these figures:
fig. 1 is a perspective view of the prosthesis described and shown;
FIG. 2 is a perspective view of the left half of the prosthesis;
FIG. 3 is a perspective view of a gauze sleeve of the prosthesis;
FIG. 4 is a side view of a gauze sleeve;
FIG. 5 is a rear view of the gauze sleeve;
FIG. 6 is a distal end elevational view of the prosthesis;
FIG. 7 is a proximal end elevational view of the prosthesis shown with a flaccid penis;
FIG. 8 is another proximal end elevational view of the prosthesis showing a engorged penis; and
figure 9 is a cross-sectional view of a human penis.
Detailed Description
The foregoing drawings illustrate the present invention in at least one preferred embodiment thereof, which is defined in further detail in the following description.
The present invention is a penile prosthesis of silicone rubber or equivalent material that may be subcutaneously implanted in a human penis 5. Fig. 9 is a sectional view showing the anatomical structure of the penis 5, specifically showing the dorsal vein 6a, the deep dorsal vein 6b, the dorsal artery and nerve 6c, the cavernous penis 6d, the deep artery 6e, the urethral cavernous body and urethra 6f, the tunica albuginea 6g, the cavernous septa 6h of the buck's fascia, the tunica albuginea 6i of the cavernous penis, the buck's fascia 6j, the tunica fascia 6k, and the skin 6l as the outer layer of the penis 5.
As shown in fig. 1, the prosthesis may have a barrel 10 of selected longitudinal length coinciding with the long axis 4 of the penis 5 and may be opened at its proximal end 20 (closest to the testicle) and at its opposite distal end 30 (closest to the glans penis). The body 10 may have an inner surface 50 and an outer surface 60 and may be formed as a single integral part with two connected halves 10A, 10B or alternatively, as shown in fig. 1, may be formed as two separate halves 10A, 10B that may be later connected together. The halves 10A, 10B may be mirror images of each other as shown, and may be connected before or during implantation into the penis 5. The prosthetic implant procedure is taught in Finney, U.S. patent No.4202530, which is incorporated by reference in the present application. Thus, it is apparent that the prosthesis may be formed to have a size and shape suitable for subcutaneous implantation under the external skin 6l and adjacent to the Bucky's fascia 6 h. The prosthesis may extend from the base of the penis 5 at its proximal end 20 to the glans penis (not shown) at its distal end 30. The inner and outer surfaces 50, 60 may have a silicon mesh 70 embedded directly beneath these surfaces as shown in fig. 1 and 2, wherein the mesh 70 may extend continuously beyond and/or under both halves 10A, 10B, and thus act as a hinge between the halves along the joining line 100. Thus, the halves 10A and 10B can be moved between the two positions shown in FIGS. 7 and 8. The prosthesis, when positioned adjacent to the Buchner's fascia 6j, may be anchored to the Buchner's fascia 6j, or to the tunica albuginea 6g, or to both the Buchner's fascia and the tunica albuginea, using sutures connecting the mesh 70.
As shown in fig. 1 and 2, a rib 15 of silicone rubber or equivalent material may be connected to the body 10 and/or to the mesh 70 or to both the body and the mesh along a joining line 100. The press rib 15 may extend only partially or fully over the length of the body 10. The hardness of the material of the press rib 15 is selected to be effective in the pressing action shown in fig. 8. The function of the ribs 15 will be discussed below in connection with the description of fig. 6-8.
Body 10 may have a circumferentially varying wall thickness from a maximum thickness along junction line 100 in fig. 1 to a minimum thickness along bottom edge 90. It should be clear that fig. 1 shows the body 10 when the two halves 10A, 10B are connected along a joining line 100. The wall thickness of body 10 may also vary longitudinally from a maximum thickness at proximal end 20 to a minimum thickness at distal end 30. As shown in fig. 1 and 6-8, the edges 90 may be spaced apart, and the gap may extend the full length of the body 10.
The thicker wall at the proximal end 20 provides the advantage of improved prosthesis rigidity when placed adjacent the penis, and the thinner wall at the distal end 30 adjacent the glans penis allows for improved movement of the glans penis. The uniform taper from the proximal end 20 to the distal end 30 provides improved flexibility of the penis when flaccid. Greater structural strength is provided along the thicker walls of the junction line 100, with the highest compressive forces occurring during intercourse. The circumferential tapering generally provides improved flexibility of the penis and a more natural penile structure and appearance as well as improved blood flow, since the prosthesis wall near the glans penis may be quite thin. An important overall result of the construction of the prosthesis is the use of relatively small amounts of material while achieving sufficient stiffness and blood flow. The use of mesh 70 provides a wide range of options regarding suture placement. The use of separate halves 10A and 10B facilitates implantation and provides the opportunity to use asymmetric halves, which may be necessary for repair of damaged or malformed organs. Referring to fig. 8, the space between the bottom longitudinal edges 90 allows the penis to expand without restraint.
The interior space within the body 10 is preferably oblate because the penis 5 of the person has a height greater than a width, and preferably has a height to width ratio of about 1.12, as shown in figures 6 and 7. It has been found that this form improves blood flow and a more comfortable fit to the penis shape.
As shown in fig. 1, body 10 may be fitted with a gauze covering 110 at distal end 30, and the gauze covering may also be secured to the body by sutures 112 as shown. Fig. 3-5 show that gauze sheath 110 may have the same shape as distal end 30 of body 10, such that gauze sheath 110 may fit over against the terminal edge of distal end 30, and may rest against inner surface 50 as well as outer surface 60 of body 10, such that gauze sheath does not create a bulky area adjacent to the glans penis and provides improved implantation. The gauze sheath 110 provides a functional means of suturing the distal end 30 of the body 10 to the Bucky's fascia 6h so that the body 10 cannot move longitudinally.
Fig. 6 shows the prosthesis as viewed from the distal end 30 towards the proximal end 20, while fig. 7 and 8 show the prosthesis as viewed from the proximal end 20 towards the distal end 30, with the addition of the buck's fascia 6h shown in dashed outline. The skin 6l is not shown in fig. 6, 7 or 8. The deep dorsal vein 6b is shown in the 12 o' clock position (below the junction line 100) in fig. 7 and 8, while fig. 7 shows a flaccid penis 5 and fig. 8 shows an erect or engorged penis 5. The compression rib 15 is shown compressing the deep dorsal vein 6b to slow the outward blood flow during the erection process and to maintain the erect state.
While the invention has been described with reference to at least one preferred embodiment, it will be understood by those skilled in the art that the invention is not limited thereto. Rather, the scope of the invention is to be construed only in conjunction with the appended claims.