Method of treating urinary incontinence by implanting a transvaginal mid-urethral sling into a person

Abstract

A method of treating urinary incontinence by implanting a transvaginal mid-urethral sling into a person includes engaging an introducer needle with an extension of an implant; advancing the introducer needle and the extension of the implant from a vaginal incision, along a first path posterior to a pubic bone, and through an abdomen of the patient; and disengaging the introducer needle from the extension of the implant and withdrawing the introducer needle backward along the first path from posterior to the pubic bone out of the vaginal incision.

What is claimed is: 
     
         1 . A method of treating urinary incontinence by implanting a transvaginal mid-urethral sling into a person, the method comprising:
 forming a vaginal incision in a vaginal wall of a patient for access to a urethra;   providing an implant having a middle urethra support, a first extension attached to a first end portion of the middle urethra support, and a second extension attached to a second end portion of the middle urethra support, where each of the first extension and the second extension is a tube of material;   providing an introducer needle having a body that terminates in a tip, where the tip is adapted to dissect tissue;   engaging the introducer needle with the first extension of the implant prior to passage of the implant into the patient;   advancing the introducer needle and the first extension of the implant from the vaginal incision, along a first path posterior to a pubic bone, and through an abdomen of the patient;   disengaging the introducer needle from the first extension of the implant and withdrawing the introducer needle backward along the first path from posterior to the pubic bone out of the vaginal incision;   pulling on the first extension of the implant and positioning the middle urethra support beneath the urethra;   passing the introducer needle and the second extension of the implant from the vaginal incision, along a second path posterior to the pubic bone, and through the abdomen of the patient; and   removing the first extension and the second extension from the middle urethra support.   
     
     
         2 . The method of  claim 1 , further comprising:
 compressing the first extension onto the introducer needle and securing the first extension to the introducer needle.   
     
     
         3 . The method of  claim 1 , wherein each of the first extension and the second extension is molded of a polymeric material, and engaging the introducer needle with the first extension of the implant comprises engaging the introducer needle with the molded polymeric material. 
     
     
         4 . The method of  claim 1 , further comprising:
 forming a first incision in the abdomen of the patient and advancing the introducer needle and the first extension of the implant from the vaginal incision, along the first path posterior to the pubic bone, and through the first incision in the abdomen of the patient.   
     
     
         5 . The method of  claim 1 , further comprising:
 forming a second incision in the abdomen of the patient and passing the introducer needle and the second extension of the implant from the vaginal incision, along the second path posterior to the pubic bone, and through the second incision in the abdomen of the patient.   
     
     
         6 . The method of  claim 1 , further comprising:
 advancing the introducer needle and the first extension of the implant from the vaginal incision, along the first path posterior to the pubic bone, pushing the tip of the introducer needle through the abdomen of the patient, and leaving the first extension protruding outward from the abdomen of the patient.   
     
     
         7 . The method of  claim 1 , further comprising:
 using the first extension and the second extension to adjust a position of the implant in the patient.   
     
     
         8 . The method of  claim 1 , further comprising:
 advancing the introducer needle and the first extension of the implant from the vaginal incision, through a retropubic space and through the abdomen of the patient;   disengaging the introducer needle from the first extension of the implant and withdrawing the introducer needle from the retropubic space and out of the vaginal incision.   
     
     
         9 . A method of treating urinary incontinence by implanting a transvaginal mid-urethral sling into a person, the method comprising:
 forming a vaginal incision in a vaginal wall of a patient for access to a urethra;   forming a first abdominal incision and a second abdominal incision in the patient;   providing an implant having a middle urethra support, a first extension attached to a first end portion of the middle urethra support, and a second extension attached to a second end portion of the middle urethra support, where each of the first extension and the second extension is a tube of material;   providing an introducer needle having a body with a first end that is permanently secured to a handle and a second end that terminates in a tip;   engaging the introducer needle with the first extension of the implant;   advancing the introducer needle and the first extension of the implant from the vaginal incision, along a first path posterior to a pubic bone, and through the first abdominal incision of the patient;   disengaging the introducer needle from the first extension of the implant and withdrawing the introducer needle backward along the first path from posterior to the pubic bone out of the vaginal incision;   engaging the introducer needle with the second extension of the implant;   advancing the introducer needle and the second extension of the implant from the vaginal incision, along a second path posterior to the pubic bone, and through the second abdominal incision of the patient;   disengaging the introducer needle from the second extension of the implant and withdrawing the introducer needle backward along the second path from posterior to the pubic bone out of the vaginal incision;   pulling on the first extension and the second extension of the implant and positioning the middle urethra support beneath the urethra; and   removing the first extension and the second extension from the middle urethra support.   
     
     
         10 . The method of  claim 9 , wherein each of the first extension and the second extension is molded of a polymeric material, and engaging the introducer needle with the first extension of the implant comprises engaging the introducer needle with the molded polymeric material. 
     
     
         11 . A method of treating urinary incontinence by implanting a transvaginal mid-urethral sling into a person, the method comprising:
 forming a vaginal incision in a vaginal wall of a patient for access to a urethra;   forming a first abdominal incision and a second abdominal incision in the patient;   providing an implant having a middle urethra support, a first extension attached to a first end portion of the middle urethra support, and a second extension attached to a second end portion of the middle urethra support, where each of the first extension and the second extension is a tube of material;   providing an introducer needle having a body with a first end that is secured to a handle and a second end that terminates in a tip;   engaging the introducer needle with the first extension of the implant;   advancing the introducer needle and the first extension of the implant from the vaginal incision, along a first path through a retropubic space posterior to a pubic bone, and through the first abdominal incision of the patient;   disengaging the introducer needle from the first extension of the implant, withdrawing the introducer needle backward along the first path out of the retropubic space and out of the vaginal incision, and leaving the first extension protruding outward from an abdomen of the patient;   engaging the introducer needle with the second extension of the implant;   advancing the introducer needle and the second extension of the implant from the vaginal incision, along a second path through the retropubic space posterior to the pubic bone, and through the second abdominal incision of the patient;   disengaging the introducer needle from the second extension of the implant, withdrawing the introducer needle backward along the second path out of the retropubic space and out of the vaginal incision, and leaving the second extension protruding outward from the abdomen of the patient;   pulling on the first extension and the second extension of the implant and positioning the middle urethra support beneath the urethra; and   removing the first extension and the second extension from the middle urethra support.