US 3369542 A
Description (OCR text may contain errors)
Feb. 20, 1968 J. H. THAIDIGSM'AN 3,369,542
URINARY INSERTION DEVI CE Filed May 14, 1965 2 Sheets-Sheet 2 v Z1 :Q 7
IN VEN TOR. v
The present invention related to surgical insertion devices and more particularly, to an insertion device to aid in the examination of a female urinary bladder.
The purpose of the device is to permit the insertion of a dye medium and a flexible, longitudinally extending metallic bead chain into the female urinary bladder and urethra with a minimum of distress and danger to the patient.
,A further purpose is to introduce both a dye medium and a flexible metallic bead chain into the female urinary bladder and urethra with a single device which requires a single insertion.
A further purpose is to eliminate the use of a forcep for inserting a metal chain into the female urinary bladder.
A further purpose is to eliminate the use of a longitudinally split rubber tube or catheter for insering a metal chain into the female urinary bladder for examination purposes.
A further purpose is to achieve complete control of a metal chain during the insertion of the chain into a female urinary bladder during a test procedure.
A further purpose is to permit an eflicient introduction of a liquid dye or contrast media into the bladder during a test process so that a single manipulation is required for the insertion of both the liquid and the metal chain.
Further purposes appear in the specification and in the claims.
In the drawings I have chosen to illustrate a few only of the numerous embodiments in which my invention may appear, selecting the forms shown from the standpoints of convenience in illustration, satisfactory operation and clear demonstration of the principles involved.
FIGURE 1 is a side elevation of the insertion device of the invention.
FIGURE 2 is a top plan view of the device of FIG- URE 1.
FIGURE 3 is an enlarged fragmentary section taken on the line 3-3 of FIGURE 2.
FIGURE 4 is a fragmentary section taken on the line 44 of FIGURE 3.
FIGURES 5 to show the use of the device on a patient.
FIGURE 5 is an elevational view showing the device being inserted into the bladder.
FIGURE 6 is an elevational view showing the dye being ejected into the bladder.
FIGURE 7 is a fragmentary plan view of the device showing the dye flowing into the bladder.
FIGURE 8 is an elevational view showing the chain being inserted into the bladder.
FIGURE 9 shows the device retracted and removed.
FIGURE 10 shows the chain remaining in the bladder and urethra to the urethral orifice and the end of the wire taped to the patients leg.
In examination for urinary stress incontinence in a female, a radio opaque liquid contrast media or dye and a metallic bead chain are often used to study urethral configuration. The bladder is distended with the radio opaque liquid contrast media and the flexible bead chain is placed in the urethra to demonstrate the contour of the bladder and urethra on X-rays taken with the patient in various positions. A typical chain is 25 centimeters in length and the metallic beads of the chain are 3 millitates Patent 0 3,369,542 Patented Feb. 20, 1968 meters in diameter and are separated by connecting rods 1.5 millimeters in length.
In the prior art the contrast media was first introduced through a catheter to distend the bladder. The flexible bead chain was then introduced in a variety of ways. The dye and chain were introduced by separate insertions. In one technique of chain insertion, the front end of the chain was grasped with a flexible forcep and manipulated into the bladder. In an alternative method, the chain was enclosed with a longitudinally split rubber tube or catheter, after which the catheter was inserted into the urethra for a distance of 12 centimeters. To disengage the chain from the catheter, the external end was held taut as the catheter was further introduced. This maneuver liberated the chain from the catheter which could then be withdrawn, leaving the chain in place in the urethra and bladder.
The forcep method is often painful and requires the services of a highly skilled medical practitioner. The catheter method is uncertain and lacks positive control since it requires the chain to fall out of the catheter when the catheter is rotated and in many instances this does not occur. Additional manipulation of the catheter to deposit the chain often caused painful irritation. As with the forcep method, this method called for the services of a highly skilled medical practitioner.
In both prior art methods, several catheterizations are required to introduce the contrast media and the chain. This results in increased opportunity for infection with each manipulation.
Additionally, liquid contrast media already in place in the distended bladder often interfered with eflicient introduction of the bead chain.
In the present invention, the dye and the chain are inserted into a female urinary bladder simply, relatively painlessly and quickly, by means of a device which provides full control of the dye and the chain during the insertion. The dye and chain are introduced through the same device. There is no need for great skill in the use of the device of the present invention. Additionally, the device allows a high order of sterile technique throughout the operation.
Considering now the drawings in detail, I show in FIG- URES 1 and 2 the insertion device 20 having a tubular portion 21, a housing portion 22, and a syringe receptacle portion 23. The tubular portion 21 comprises a straight segment 25 and a curved segment 26 having radially extending holes 27 and 28. Portion 21 is hollow having a bore 30 and is bluntly tapered at 32 to a closed and rounded end. The bore 30 is curved smoothly at 33 and leads into hole 27. Hole 28 connects with the bore 30. I
Portion 21 extends into bore 35 in housing 22 and is held secured therein by O-ring 36. Bore 37 in housing 22 extends in line with bore 33 and tapers at 38 to bore 40 having bushing 41 fitted therein.
Passage 42 extends thru housing 22 and connects with main bore 37 at 43. The syringe receptacle 23 is suitably secured to the housing and is adapted to receive a standard medical syringe. A cap portion 45 is placed in the syringe portion 23 to close the opening when a syringe is not connected to the receptacle 23.
In operation, a metallic bead chain is used, comprising metallic beads 51 separated by connecting rods 52. A typical chain has beads 3 millimeters in diameter and connecting rods 1 /2 millimeters in length. The metallic bead chain 50 is, for instance, 25 centimeters in length and has attached at one end a flexible metallic wire 53 having a circular cross-section and attached to the chain by any convenient means. The wire is of a length of, for instance, 18 inches whereby it can extend from the bladder to the outside of the patient when the chain is inserted in the patient. The chain is loaded into the device 20 by first extending the end of the wire 53 at 55 into bore opening 27 and forcing the wire 53 along the bore 30 until it is guided into bushing 41 by tapered sides 56. The wire 53 is of a slightly less diameter than the hole in bushing 41 so that the clearance is very little and a close fit between the wire 53 and bushing 41 is obtained while at the same time the wire is allowed to freely pass through the bushing. After the end 55-passes through the bushing from inside the housing 22 to outside the housing, the end 55 is grasped and substantially the entire wire is pulled through the bushing until the chain 50 is pulled into the bore 30 of the tubular portion 21. When the bead chain is pulled to a position at which the end bead 57 abuts against tapered sides 56 the entire length of the bead chain will be enclosed within the tubular portion 28, as shown in FIGURES 4 and 5.
The device 20 is now ready to be inserted into the patient. As seen in FIGURE 5, the tubular portion 21 is inserted into the patient through the urethra until the curved segment 26 of the portion 21 enters the neck of the bladder 60. The curved portion 26 may extend in any direction the operator desires to facilitate entry into the bladder, including in an upward direction as shown in FIGURES and 6. The blunt-nosed tapered portion 32 at the end of the curved segment 26 cases the entry of segment 21 so that a minimumof discomfort and pain is imparted to the patient.
After the device has been inserted'as shown in FIG- URE 5, a syringe 61 of a conventional type is inserted into the syringe receptacle 23, as seen in FIGURE 6, and held therein by means of a slip lit. The syringe 61 is filled with a suitable liquid dye, or contrast media, which is subsequently injected through passage 42 into bore 33 and into the bladder through side part 28 as shown by arrow 62 and also through 27 as shown by arrow 63 of FIG- URE 7. Plunger 61 is pushed in the direction of arrow 61 to eject the dye.
After the dye has been injected into the bladder, the
wire 53 'is pushed through bushing 41 in the direction of arrow54 andin turn metallic bead chain 30 is deposited in the direction 54 into the bladder as seen inFIGURE 8. The bead chain is guided from the bore 30 in the direction of the arrow 56 as best seen in FIGURE 4, where the emerging chain is shown in phantom at 57.
The insertion device is then removed from the urethra 65' as shown by arrow 66.- The chain is then pulled into the urethra until it appears at the urethral orifice 69 by traction on the wire 53, as shown in FIG- URE 10. The wire 53is then taped with a tape segment 68to the leg 70 of the patient as shown in FIGURE 10. It will be noted that the bead chain is capable of contracting and extending longitudinally along the connecting links in a well known fashion.
The patient is then put through a series of tests in which the body is moved in various directions to achieve different extensions of the bladder, and suitable X-rays are made in the conventional manner. At the conclusion of the test the metallic bead chain is removed by means of wire 53.
In view of my invention and disclosure, variations and modifications to meet individual whim or particular need will doubtless become evident to others skilled in the art, to obtain all or part of the benefits of my invention without copyingthe structure shown, and I, therefore, claim all such insofar as they fall within the reasonable spirit and scope of my claims.
Having thus described my invention, What I claim as new and desire to secure by Letters Patent is:
1. In a device for inserting a metallic bead chain having a wire extension into a human female urinary bladder through the urethra and depositing dye into the bladder, a tubular portion having a longitudinal bore extending therein adapted to receive the bead chain and having an outlet from the longitudinal bore, and a housing receiving and supporting the tubular portion and having a first bore in the housing extending in elongation of the tubular portion longitudinal bore passing to the exterior of the housing and adapted to pass therethrough the wire extension of the bead chain and a second bore intersecting the first bore and having at the outside end thereof a syringe receptacle, whereby the tubular portion can be extended through the female urethra to position the tubular portion longitudinal bore outlet within the bladder so that the chain can be deposited within the bladder and a liquid dye injected through the first and secondhousing bores and the longitudinally extending tubular bore into the bladder.
2. A device of claim 1 wherein the tubular portion is curved at one end thereof;
3. A device of claim 1 wherein the tubular portion is removably supported within the housing.
4. A device of claim 3 wherein the tubular portion is held Within the housing by an O-ring.
5. A device of claim 1 wherein the tubular portion is closed and tapered at one end.
6. A device of claim 1 whereinthe closed tubular end is beveled and-acts as a bafiie to direct the chain through an opening on the lateral surface of the .hollow tube.
References Cited UNITED STATES PATENTS 3,227,154 1/1966 Cook 128-2 RICHARD A. GAUDET, Primary Examiner.
SIMON BRODER, Examiner.