Register or Login To Download This Patent As A PDF
| United States Patent Application |
20030125768
|
| Kind Code
|
A1
|
|
Peter, Forsell
|
July 3, 2003
|
Impotence treatment apparatus with energy transforming means
Abstract
A male sexual impotence treatment apparatus includes or use an operable
restriction device implantable in a male patient for engaging a tissue
portion of the penile tissue to form a restrictable passageway for the
penile exit blood flow. An energy transmission device is provided for
wireless transmission of energy from outside the patient's body to inside
the patient's body for use in connection with the operation of the
restriction device, including temporarily contracting said tissue portion
to restrict the penile exit blood flow in the blood flow passageway to
achieve erection.
| Inventors: |
Peter, Forsell; (Zug, CH)
|
| Correspondence Address:
|
Nixon & Vanderhye
8th Floor
1100 North Glebe Road
Arlington
VA
22201-4714
US
|
| Serial No.:
|
203085 |
| Series Code:
|
10
|
| Filed:
|
November 19, 2002 |
| PCT Filed:
|
February 9, 2001 |
| PCT NO:
|
PCT/SE01/00268 |
| Current U.S. Class: |
607/2 |
| Class at Publication: |
607/2 |
| International Class: |
A61N 001/00 |
Claims
1. A male sexual impotence treatment apparatus, comprising an operable
restriction device implantable in an impotent patient for engaging a
tissue portion of the normal penile tissue or the prolongation thereof to
form a restrictable penile exit blood flow passageway, characterised by
an energy transmission device for wireless transmission of energy from
outside the patient's body to inside the patient's body for use in
connection with the operation of the restriction device, including
temporarily contracting said tissue portion to restrict the penile exit
blood flow in the blood flow passageway to achieve erection.
2. An apparatus according to claim 1, wherein the energy transmission
device transmits energy of a first form and the restriction device is
operable in response to energy of a second form, and further comprising
an energy transforming device implantable in the patient for transforming
the energy of the first form wirelessly transmitted by the energy
transmission device into the energy of the second form.
3. An apparatus according to claim 2, wherein the energy of the second
form is different than the energy of the first form.
4. An apparatus according to claim 2 or 3, wherein the energy transforming
device comprises at least one element having a positive region and a
negative region, the element is capable of creating an energy field
between the positive and negative regions when exposed to the energy of
the first form transmitted by the energy transmission device, and the
energy field produces the energy of the second form.
5. An apparatus according to claim 4, wherein the element comprises an
electrical junction element, and the electrical junction element is
capable of inducing an electric field between the positive and negative
regions when exposed to the energy of the first form transmitted by the
energy transmission device, whereby the energy of the second form
comprises electric energy.
6. An apparatus according to claim 5, wherein the restriction device is
electrically operated, and the positive and negative regions of the
electrical junction element supply electric energy for the operation of
the restriction device.
7. An apparatus according to claim 6, further comprising electric
conductors connected to the positive and negative regions of the
electrical junction element, whereby the electrical junction element is
capable of supplying an electric current via the conductors.
8. An apparatus according to claim 7, wherein the electrical junction
element is capable of supplying a direct current or pulsating direct
current via the conductors.
9. An apparatus according to claim 7, wherein the electrical junction
element is capable of supplying an alternating current or a combination
of a direct and alternating current via the conductors.
10. An apparatus according to claim 6, wherein the electrical junction
element is capable of supplying a frequency or amplitude modulated
signal.
11. An apparatus according to claim 6, wherein the electrical junction
element is capable of supplying an analog or digital signal.
12. An apparatus according to any of claims 2-11, wherein the energy
transforming device forms a flat and thin sheet, and has a volume of less
than 2000 cm.sup.3.
13. An apparatus according to claim 2 or 3, wherein the energy
transforming device is adapted to transform the energy of the first form
directly or indirectly into the energy of the second form.
14. An apparatus according to claim 13, further comprising an implantable
motor or pump for operating the restriction device, wherein the motor or
pump is powered by the energy of the second form.
15. An apparatus according to claim 14, wherein the energy transforming
device is adapted to directly power the motor or pump by the transformed
energy, as the energy of the second form is being transformed from the
energy of the first form.
16. An apparatus according to any of claims 13-15, wherein the wireless
energy of the first form comprises sound waves and the energy of the
second form comprises electric energy.
17. An apparatus according to any of claims 2-16, wherein the energy
transforming device comprises a capacitor and the energy of the second
form comprises electric energy.
18. An apparatus according to claim 17, wherein the capacitor is adapted
to produce electric pulses from the transformed electric energy.
19. An apparatus according to claim 18, wherein the capacitor is adapted
to produce the pulses of the electric energy, as the energy transforming
device transforms the energy of the first form transmitted by the energy
transmission device into the electric energy of the second form.
20. An apparatus according to claim 2, further comprising an implantable
stabiliser for stabilising the energy of the second form.
21. An apparatus according to claim 20, wherein the energy of the second
form comprises electric current and the stabiliser comprises at least one
capacitor.
22. An apparatus according to any of the preceding claims, further
comprising implantable electrical components including at least one
voltage level guard.
23. An apparatus according to any of claims 1-21, further comprising
implantable electrical components including a single voltage level guard.
24. An apparatus according to claim 22 or 23, wherein the electrical
components are devoid of any current detector and/or charge level
detector.
25. An apparatus according to any of claims 22-24, further comprising an
implantable capacitor or accumulator, wherein the charge or discharge of
the capacitor or accumulator is controlled by use of the voltage level
guard.
26. An apparatus according to any of claims 17-19,21 and 25, wherein the
capacitor has a capacity less than 0,1 .mu.F.
27. An apparatus according to claim 1, wherein the energy transmission
device is adapted to transmit wireless energy for direct use in
connection with the operation of the restriction device, as the wireless
energy is being transmitted.
28. An apparatus according to claim 27, further comprising an implantable
motor or pump for operating the restriction device, wherein the energy
transmission device is adapted to directly power the motor or pump with
wireless energy.
29. An apparatus according to claim 28, wherein the energy transmission
device is adapted to transmit wireless energy in the form of a magnetic
field or electromagnetic waves for direct power of the motor or pump
30. An apparatus according to claim 2, wherein the energy transforming
device is adapted to supply the energy of the second form for direct use
in connection with the operation of the restriction device, as the energy
of the first form is being transformed into the energy of the second
form.
31. An apparatus according to claim 30, further comprising an implantable
motor or pump for operating the restriction device, wherein the energy
transforming device is adapted to directly power the motor or pump with
the energy of the second form.
32. An apparatus according to claim 31, wherein the energy transforming
device directly operates the restriction device with the energy of the
second form in a non-magnetic, non-thermal or non-mechanical manner.
33. An apparatus according to any of claims 2-12, further comprising an
implantable motor for direct or intermittent operation of the restriction
device, wherein the energy transforming device powers the motor with the
energy of the second form.
34. An apparatus according to claim 33, wherein the restriction device is
operable to perform a reversible function and the motor is capable of
reversing said function.
35. An apparatus according to any of claims 2-27 and 30, wherein the
restriction device comprises a hydraulic restriction device, and further
comprising an implantable pump for operating the hydraulic restriction
device, the energy transforming device supplying the energy of the second
form for driving the pump.
36. An apparatus according to any of claims 28,29,31 and 35, wherein the
pump is not a plunger type of pump.
37. An apparatus according to any of the preceding claims, wherein the
energy transforming device is capable of generating as the energy of the
second form a current exceeding 1 .mu.A, when transferring the energy of
the first form transmitted by the energy transmission device.
38. An apparatus according to any of the preceding claims, further
comprising an adjustment device for adjusting the restriction device to
change the restriction of the blood flow passageway, wherein the
adjustment device is adapted to mechanically adjust the restriction
device, or adapted to hydraulically adjust the restriction device by
using hydraulic means which is devoid of hydraulic fluid of the kind
having a viscosity that substantially increases when exposed to heat or a
magnetic field.
39. An apparatus according to any of claims 2-12, wherein the energy
transforming device comprises at least one semiconductor type of
component.
40. An apparatus according to claim 39, wherein the energy transforming
device comprises a circuitry of semiconductor components.
41. An apparatus according to claim 39, wherein the semiconductor
component comprises a transistor or microchip or similar electronic
components excluding rectifying diodes.
42. An apparatus according to claim 40 or 41, wherein the semiconductor
component comprises at least one element having a positive region and a
negative region, the element is capable of creating an energy field
between the positive and negative regions when exposed to the energy of
the first form transmitted by the energy transmission device, and the
energy field produces the energy of the second form.
43. An apparatus according to any of the preceding claims, further
comprising an implantable operation device for operating the restriction
device, wherein the energy transforming device powers the operation
device with the energy of the second form.
44. An apparatus according to claim 43, further comprising a control
device for controlling the operation device.
45. An apparatus according to claim 43 or 44, wherein the operation device
comprises a motor.
46. An apparatus according to claim 33 or 45, further comprising an
implantable gearing connected to the motor.
47. An apparatus according to claims 44 and 45, wherein the motor
comprises a rotary motor and the control device controls the rotary motor
to rotate a desired number of revolutions.
48. An apparatus according to claim 45, wherein the motor comprises a
linear motor.
49. An apparatus according to claim 44 and 45, wherein the motor comprises
a hydraulic or pneumatic fluid motor, and the control device controls the
fluid motor.
50. An apparatus according to claim 45, wherein the motor comprises an
electric motor having electrically conductive parts made of plastics.
51. An apparatus according to claim 43, wherein the restriction device
comprises hydraulic means and the operation device is adapted to conduct
a hydraulic fluid in the hydraulic means.
52. An apparatus according to claim 51, wherein the operation device
comprises a fluid conduit connected to the hydraulic means of the
restriction device, and a reservoir for fluid, the reservoir forming part
of the conduit.
53. An apparatus according to claim 52, wherein the hydraulic means and
conduit are devoid of any non-return valve.
54. An apparatus according to claim 53, wherein the reservoir forms a
fluid chamber with a variable volume, and the operation device is adapted
to distribute fluid from the chamber to the hydraulic means of the
restriction device by reduction of the volume of the chamber and to
withdraw fluid from the hydraulic means to the chamber by expansion of
the volume of the chamber.
55. An apparatus according to claim 54, wherein the operation device
comprises an implantable motor used for reducing and expanding the volume
of the chamber.
56. An apparatus according to any of claims 51-53, wherein the operation
device comprises an implantable pump for pumping the hydraulic fluid in
the hydraulic means of the restriction device.
57. An apparatus according to claim 44, wherein the control device shifts
polarity of the energy of the second form to reverse the operation
device.
58. An apparatus according to claim 45 or 57, wherein the operation device
comprises an electric motor and the energy of the second form comprises
electric energy.
59. An apparatus according to any of claims 1,43 and 44, wherein the
restriction device is operable to perform a reversible function.
60. An apparatus according to claim 59, further comprising a reversing
device implantable in the patient for reversing the function performed by
the restriction device.
61. An apparatus according to claims 44 and 60, wherein the control device
controls the reversing device to reverse the function performed by the
restriction device.
62. An apparatus according to claim 60 or 61, wherein the reversing device
comprises hydraulic means including a valve for shifting the flow
direction of a fluid flow in the hydraulic means.
63. An apparatus according to claim 60 or 61, wherein the reversing device
comprises a mechanical reversing device.
64. An apparatus according to claim 63, wherein the reversing device
comprises a gearbox.
65. An apparatus according to claim 60 or 61, wherein the reversing device
comprises a switch.
66. An apparatus according to claim 65, wherein the switch is operable by
the energy of the second form.
67. An apparatus according to claim 66, wherein the control device
controls the operation of the switch by shifting polarity of the energy
of the second form.
68. An apparatus according to claim 66 or 67, wherein the switch comprises
an electric switch and the energy of the second form comprises electric
energy.
69. An apparatus according to claim 43, wherein the operation device
comprises hydraulic means and at least one valve for controlling a fluid
flow in the hydraulic means.
70. An apparatus according to claim 69, further comprising a wireless
remote control for controlling the valve.
71. An apparatus according to any one of claims 18,19 and 44, wherein the
control device is adapted to control the energy transforming device to
produce the energy of the second form in a train of energy pulses for
direct use in connection with the operation of the restriction device.
72. An apparatus according to claim 2, further comprising an energy
storage device implantable in the patient for storing the energy of the
second form and for supplying energy in connection with the operation of
the restriction device.
73. An apparatus according to claim 72, wherein the energy storage device
comprises an accumulator.
74. An apparatus according to claim 73, wherein the energy of the second
form comprises electric energy and the energy storage device comprises an
electric accumulator.
75. An apparatus according to claim 74, wherein the electric accumulator
comprises at least one capacitor or at least one rechargeable battery, or
a combination of at least one capacitor and at least one rechargeable
battery.
76. An apparatus according to any of claims 2,65,71-75, further comprising
a switch implantable in the patient for directly or indirectly switching
the operation of the restriction device.
77. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient, wherein the switch is operated by the
energy of the second form supplied by the energy storage device to switch
from an off mode, in which the source of energy is not in use, to an on
mode, in which the source of energy supplies energy for the operation of
the restriction device.
78. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient, and a remote control for controlling
the supply of energy of the source of energy, wherein the switch is
operated by the energy of the second form supplied by the energy storage
device to switch from an off mode, in which the remote control is
prevented from controlling the source of energy and the source of energy
is not in use, to a standby mode, in which the remote control is
permitted to control the source of energy to supply energy for the
operation of the restriction device.
79. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient for supplying energy for the operation
of the restriction device, wherein the switch is operated by the energy
of the second form supplied by the energy transforming device to switch
from an off mode, in which the source of energy is not in use, to an on
mode, in which the source of energy supplies energy for the operation of
the restriction device.
80. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient for supplying energy for the operation
of the restriction device, and a remote control for controlling the
supply of energy of the implantable source of energy, wherein the switch
is operated by the energy of the second form supplied by the energy
transforming device to switch from an off mode, in which the remote
control is prevented from controlling the source of energy and the source
of energy is not in use, to a standby mode, in which the remote control
is permitted to control the source of energy to supply energy for the
operation of the restriction device.
81. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient for supplying energy for the operation
of the restriction device, wherein the switch is operated by the energy
of the first form supplied by the energy transmission device to switch
from an off mode, in which the source of energy is not in use, to an on
mode, in which the source of energy supplies energy for the operation of
the restriction device.
82. An apparatus according to claim 76, further comprising a source of
energy implantable in the patient for supplying energy for the operation
of the restriction device, and a remote control for controlling the
supply of energy of the implantable source of energy, wherein the switch
is operated by the energy of the first form supplied by the energy
transmission device to switch from an off mode, in which the remote
control is prevented from controlling the source of energy and the source
of energy is not in use, to a standby mode, in which the remote control
is permitted to control the source of energy to supply energy for the
operation of the restriction device.
83. An apparatus according to claim 2, wherein the restriction device is
electrically operated, and the energy of the second form comprises
electric energy.
84. An apparatus according to claim 83, further comprising electric
conductors connected to the energy transforming device, whereby the
energy transforming device is capable of supplying an electric current
via the conductors.
85. An apparatus according to claim 2, wherein the energy transforming
device is capable of supplying a frequency, amplitude or frequency and
amplitude modulated signal.
86. An apparatus according to claim 2, wherein the energy transforming
device is capable of supplying an analog, digital or a combination of an
analog and digital signal.
87. An apparatus according to claim 1, further comprising an activatable
source of energy implantable in the patient, wherein the source of energy
is activated by wireless energy transmitted by the energy transmission
device, to supply energy which is used in connection with the operation
of the restriction device.
88. An apparatus according to claim 1, wherein the energy transmission
device transmits energy by at least one wireless signal.
89. An apparatus according to claim 88, wherein the signal contains
radiant energy.
90. An apparatus according to claim 88, wherein the signal comprises a
wave signal.
91. An apparatus according to claim 90, wherein the wave signal comprises
an electromagnetic wave signal including one of an infrared light signal,
a visible light signal, an ultra violet light signal, a laser signal, a
micro wave signal, a radio wave signal, an x-ray radiation signal, and a
gamma radiation signal.
92. An apparatus according to claim 90, wherein the wave signal comprises
a sound or ultrasound wave signal.
93. An apparatus according to any one of claims 88-92, wherein the signal
comprises a digital or analog signal, or a combination of a digital and
analog signal.
94. An apparatus according to claim 2, wherein the energy of the first
form transmitted by the energy transmission device comprises an electric,
an electromagnetic or a magnetic field, or a combination thereof.
95. An apparatus according to claim 94, wherein the electric,
electromagnetic or magnetic field, or the combination thereof is
transmitted in pulses or digital pulses, or a combination of pulses and
digital pulses by the energy transmission device.
96. An apparatus according to claim 2, wherein the energy of a first form
transmitted by the energy transmission device comprises an electric, an
electromagnetic or a magnetic field, or a combination thereof.
97. An apparatus according to claim 96, wherein the electric,
electromagnetic or magnetic field, or the combination thereof is
transmitted in waves or analog pulses or a combination thereof by the
energy transmission device.
98. An apparatus according to any one of claims 1-97, wherein the energy
transmitted by the energy transmission device comprises polarised energy.
99. An apparatus according to claim 2, wherein the energy transforming
device transforms the energy of the first form into a direct current or
pulsating direct current, or a combination of a direct current and
pulsating direct current.
100. An apparatus according to claim 2, wherein the energy transforming
device transforms the energy of the first form into an alternating
current or a combination of a direct and alternating current.
101. An apparatus according to claim 2, further comprising an implantable
pulse generator for generating electrical pulses from the energy of the
second form produced by the energy field.
102. An apparatus according to any one of the preceding claims, further
comprising at least one implantable sensor for sensing at least one
physical parameter of the patient.
103. An apparatus according to claim 102, wherein the sensor comprises a
pressure sensor for directly or indirectly sensing as the physical
parameter the pressure in the blood flow passageway.
104. An apparatus according to claim 102, further comprising a control
device for controlling the restriction device in response to signals from
the sensor.
105. An apparatus according to claim 104, wherein the control device
comprises an internal control unit implantable in the patient for
controlling the restriction device in response to signals from the
sensor.
106. An apparatus according to claim 105, wherein the internal control
unit directly controls the restriction device in response to signals from
the sensor.
107. An apparatus according to claim 104, wherein the control device
comprises an external control unit outside the patient's body for
controlling the restriction device in response to signals from the
sensor.
108. An apparatus according to claim 107, wherein the external control
unit stores information on the physical parameter sensed by the sensor
and is manually operated to control the restriction device based on the
stored information.
109. An apparatus according to any one of claims 102-108, further
comprising at least one implantable sender for sending information on the
physical parameter sensed by the sensor.
110. An apparatus according to any one of the preceding claims, further
comprising a wireless remote control for transmitting at least one
wireless control signal for controlling the restriction device.
111. An apparatus according to claim 110, wherein the control signal
comprises a frequency, amplitude or frequency or amplitude modulated
signal.
112. An apparatus according to claim 110, wherein the control signal
comprises an analog or a digital signal, or a combination of an analog
and digital signal.
113. An apparatus according to any of claims 110-112, wherein the remote
control is capable of obtaining information on the condition of the
implantable restriction device and to control the restriction device in
response to the information.
114. An apparatus according to any of claims 110-113, wherein the remote
control comprises an implantable control unit for controlling the
restriction device.
115. An apparatus according to claim 114, wherein the control unit
comprises a microprocessor.
116. An apparatus according to any one of claims 110-115, wherein the
wireless remote control comprises at least one external signal
transmitter or transceiver and at least one internal signal receiver or
transceiver implantable in the patient.
117. An apparatus according to any one of claims 110-115, wherein the
wireless remote control comprises at least one external signal receiver
or transceiver and at least one internal signal transmitter or
transceiver implantable in the patient.
118. An apparatus according to any one of claims 110-117, wherein the
remote control is capable of sending information related to the
restriction device from inside the patients body to the outside thereof.
119. An apparatus according to claim 118, wherein the remote control
controls the restriction device in response to the information.
120. An apparatus according to any one of claims 110-119, wherein the
remote control comprises a control signal transmitter for transmitting
the wireless control signal, and the energy transmission device comprises
the control signal transmitter, whereby energy is transmitted by the
control signal.
121. An apparatus according to any one of claims 110-119, wherein the
energy transmission device transmits energy by at least one signal
separate from the control signal.
122. An apparatus according to any one of claims 110-119, wherein the
remote control transmits a carrier signal for carrying the control
signal.
123. An apparatus according to any one of claims 110-119, wherein the
energy transmission device transmits energy by at least one signal, which
is used as a carrier signal for the control signal transmitted by the
remote control.
124. An apparatus according to claim 123, wherein the carrier signal is
frequency, amplitude or frequency and amplitude modulated.
125. An apparatus according to claim 123 or 124, wherein the carrier
signal comprises digital, analog or a combination of digital and analog
signals.
126. An apparatus according to claim 125, wherein the signals comprise
wave signals.
127. An apparatus according to any one of claims 110-126, wherein the
control signal comprises a wave signal comprising one of a sound wave
signal, an ultrasound wave signal, an electromagnetic wave signal, an
infrared light signal, a visible light signal, an ultra violet light
signal, a laser light signal, a micro wave signal, a radio wave signal,
an x-ray radiation signal and a gamma radiation signal.
128. An apparatus according to any one of claims 110-126. wherein the
control signal comprises an electric or magnetic field, or a combined
electric and magnetic field.
129. An apparatus according to claim 112, wherein the remote control
transmits an electromagnetic carrier wave signal for carrying the digital
or analog control signal.
130. An apparatus according to claim 2, wherein the energy of the second
form used for operating the restriction device is wirelessly transmitted
by the energy transforming device.
131. An apparatus according to claim 1, further comprising an implantable
control unit for controlling the restriction device.
132. An apparatus according to claim 131, wherein the control unit is
programmable for controlling the restriction device in accordance with a
program.
133. An apparatus according to claim 131, wherein the control unit
controls the restriction device over time in accordance with an activity
schedule program
134. An apparatus according to any one of claims 131-133, further
comprising an external wireless remote control for programming the
implantable control unit.
135. An apparatus according to claim 1, further comprising an external
data communicator and an implantable internal data communicator
communicating with the external data communicator, wherein the internal
communicator feeds data related to the restriction device back to the
external data communicator or the external data communicator feeds data
to the internal data communicator.
136. An apparatus according to claim 135, wherein the internal data
communicator feeds data related to at least one physical signal of the
patient.
137. An apparatus according to any one of the preceding claims, wherein
the restriction device is adapted to control the restriction of the blood
flow passageway when implanted.
138. An apparatus according to any one of the preceding claims, wherein
the restriction device is non-inflatable.
139. An apparatus according to claim 2, wherein one of the energy of the
first form and the energy of the second form comprises magnetic energy,
kinetic energy, sound energy, chemical energy, radiant energy,
electromagnetic energy, p
hoto energy, nuclear energy or thermal energy.
140. An apparatus according to claim 2, wherein one of the energy of the
first form and the energy of the second form is non-magnetic,
non-kinetic, non-chemical, non-sonic, non-nuclear or non-thermal.
141. An apparatus according to claim 1, wherein the energy transmission
device functions different from the energy transforming device.
142. An apparatus according to claim 2, wherein the energy transmission
device functions similar to the energy transforming device.
143. An apparatus according to any one of the preceding claims, wherein
the energy transforming device is designed to be implanted subcutaneously
or in the abdomen, thorax or cephalic region of the patient.
144. An apparatus according to any one of claims 1-142, wherein the energy
transforming device is designed to be implanted in an orifice of the
patient's body and under the mucosa or intraluminar outside the mucosa of
the orifice.
145. An apparatus according to any one of claims 1-142, wherein the energy
transforming means is designed to be implanted in the retropritoneum or
in the scrotum of the patient.
146. An apparatus according to any of the preceding claims, wherein the
restriction device is embedded in a soft or gel-like material.
147. An apparatus according to any of the preceding claims, wherein the
restriction device is embedded in a silicone material having hardness
less than 20 Shore.
148. An apparatus according to claim 102, wherein the sensor is adapted to
sense ejaculation as the physical parameter, and the restriction device
is adapted to release the penile tissue or the prolongation thereof in
response to the sensor sensing ejaculation.
Description
[0001] The present invention relates to a male sexual impotence treatment
apparatus, comprising an operable restriction device implantable in an
impotent patient for engaging a tissue portion of the normal penile
tissue or the prolongation thereof to form a restrictable penile exit
blood flow passageway.
[0002] The expression "normal penile tissue or the prolongation thereof"
should be understood to mean the penile tissue extended inside the human
body and following the pathway of the blood flow leaving the penis i.e.
one or more exit veins from the penis, the corpus cavernosum, crura or
the prolongation thereof.
[0003] Male sexual impotence is a widespread problem. Many different
solutions to this problem have been tried. A solution currently practiced
is to replace the corpus cavernosa in the penis with a hydraulic
inflatable/contractable silicon prosthesis, thus implanted in the penis.
In fluid connection with this prosthesis is a reservoir implanted in the
scrotum. By manual pumping action the prosthesis is filled with fluid
from the reservoir to effect errect penile condition or is emptied of
fluid, which returns to the reservoir, to effect flaccid penile
condition. However, there are several more or less severe disadvantages
of this solution. Above all, the penis is more or less damaged by the
operation and it is practically impossible to reverse the operation.
Another disadvantage is that rather strong forces act against this
implanted prosthesis resulting in a significant risk of the prosthesis
being broken.
[0004] Another solution to achieve erection is to restrict the blood flow
leaving the penis. For example, U.S. Pat. Nos. 4,829,990, 4,958,630 and
5,048,511 disclose two hydraulically operated inflatable cuffs wrapped
around respective crura or veins. A disadvantage of such a solution is
that it involves complicated surgery. Another example on this solution is
U.S. Pat. No. 4,828,544, which discloses an artificial fistula system
surgically implanted and providing a primary fistula between the femoral
artery and the femoral vein and a secondary fistula for leading blood
from the the primary fistula to the penis. The inflatable balloon engages
the primary fistula between the secondary fistula and the vein. The
balloon is in fluid connection with a manually compressible reservoir
implanted in the scrotum. Again, implantation of this artifical fistula
system requires delicate surgery. Yet another solution is to inject a
substance in the penile vein system to achieve erection. However,
injections are painful and complicated for the patient.
[0005] The object of the present invention is to provide a simple male
sexual impotence treatment apparatus, which is conveniently controlled by
the patient.
[0006] This object is obtained by an apparatus of the kind stated
initially characterised by an energy transmission device for wireless
transmission of energy from outside the patient's body to inside the
patient's body for use in connection with the operation of the
restriction device, including temporarily contracting said tissue portion
to restrict the penile exit blood flow in the blood flow passageway to
achieve erection.
[0007] As a result, the advantage is achieved that the impotence treatment
apparatus of the invention provides simple and effective energy
transmission which ensures an extended and reliable functionality of the
apparatus, possibly for the rest of the patient's natural life, and at
least many years.
[0008] The restriction device preferably controls the cross-sectional area
of the passageway through which blood flow leaves the penis, which gives
the advantage that the patient is enabled to adjust the restriction
device to acheive the desired erection without feeling pain. This
advantage should not be underestimated, because fine adjustments to
restrict the cross-sectional area of the passageway, will allow maximal
erection with minimum of restriction.
[0009] Generally, the apparatus comprises an energy transforming device
implantable in the patient for transforming the energy wirelessly
transmitted by the energy transmission device from a first form into a
second form, preferably different than the first form.
[0010] The energy transforming device may comprise at least one
semiconductor type of component or a circuitry of such semiconductor
components. The semiconductor component may comprise a transistor or
microchip or similar electronic components. However, the semiconductor
component may not comprise rectifying diodes.
[0011] In accordance with a main embodiment of the invention, the energy
transforming device comprises at least one element having a positive
region and a negative region and adapted to create an energy field
between the positive and negative regions when exposed to the energy of
the first form transmitted by the energy transmission device, so that the
energy field provides the energy of the second form. Typically, the
above-mentioned semiconductor component may include such an element.
[0012] In accordance with a preferred embodiment of the invention, the
element comprises an electrical junction element capable of inducing an
electric field between the positive and negative regions when exposed to
the energy of the first form transmitted by the energy transmission
device, whereby the energy of the second form comprises electric energy.
[0013] Consequently, the restriction device suitably is electrically
operated, whereby the positive and negative regions of the electrical
junction element supply electric energy for the operation of the
restriction device. The apparatus suitably comprises implantable electric
conductors connected to the positive and negative regions of the
electrical junction element, whereby the electrical junction element is
capable of supplying an electric current, such as a direct current, a
pulsating direct current, a combination of a direct and pulsating direct
current, an alternating current or a combination of a direct and
alternating current, via the conductors. Furthermore, the electrical
junction element may be capable of supplying a frequency, amplitude, or
frequency and amplitude modulated analog, digital, or a combination of
analog and digital signal, which is used in connection with control of
the restriction device.
[0014] The element, preferably in the form of an electrical semiconductor
junction element, should be designed to generate an output current
exceeding 1 .mu.A when exposed to the energy of the first form
transmitted by the energy transmission device. Suitably the electrical
junction element forms a flat and thin sheet and has a volume of less
than 2000 cm.sup.3 to be suited for subcutaneous implantation, so that
the electrical junction element can be located just behind the skin of
the patient. Alternatively, it would be possible to implant the element
in the thorax or cephalic region of the patient, or in an orifice of the
patient's body and under the mucosa or intraluminar outside the mucosa of
the orifice. Of course, all the components of the energy transforming
device including the electrical junction element in contact with the
patient's body should be of biocompatible material.
[0015] For in vitro appliances, a particular type of an electrical
semiconductor junction element has been commonly used, namely a so-called
p-n (positive/negative) junction element, typically in the form of solar
cells. A solar cell transfers solar energy in the form of visible light
into electric energy in the form of direct current. For example, a p-n
junction element may comprise two layers of semiconductor, one p-type
(positive) and the other n-type (negative), sandwiched together to form a
"p-n junction". This p-n junction induces an electric field across the
element when absorbing quanta of light (p
hotons).
[0016] To be more precise, the quanta of light transfer their energy to
some of the semiconductor's electrons, which are then able to move about
through the material. For each such negatively charged electron, a
corresponding positive charge--a "hole"--is created. In an ordinary
semiconductor, these electrons and holes recombine after a short time and
their energy is wasted as heat. However, when the electrons and holes are
swept across the p-n junction in opposite directions by the action of the
electric field, the separation of charge induces a voltage across the p-n
junction element. By connecting the p-n junction element to an external
circuit, the electrons are able to flow thereby creating a current.
[0017] Surprisingly, it has been proved that although both the skin and
subcutis absorb energy from an external light beam directed against the
skin portion behind which a properly designed p-n junction element is
located, the light energy transmitted through the skin can induce a
current from the p-n junction element strong enough (minimum 1 .mu.A) to
enable the operation of the electrically operated restriction device.
Thus, such a p-n junction element is now for the first time used for in
vivo applications.
[0018] The apparatus may comprise an implantable pulse generator for
generating electrical pulses from the energy of the second form produced
by the energy field.
[0019] Generally, the energy transforming device is adapted to transform
the energy of the first form directly or indirectly into the energy of
the second form.
[0020] In accordance with a preferred embodiment of the invention, the
energy of the second form comprises electric energy and the energy
transforming device comprises a capacitor, which may be adapted to
produce electric pulses from the transformed electric energy. Preferably,
the capacitor may be adapted to produce the pulses as the energy
transforming device transforms the energy of the first form transmitted
by the energy transmission device into the electric energy of the second
form. The capacitor should be small to facilitate implantation thereof;
i.e. its capacity may not be more than 0,1 .mu.F.
[0021] The apparatus may comprise an implantable stabiliser for
stabilising the energy of the second form. Where the energy of the second
form comprises electric current the stabiliser may comprise at least one
capacitor of the type described above.
[0022] In most embodiments of the invention, the apparatus comprises
implantable electrical components. Where the electrical components
include a capacitor of the type described above or an accumulator, at
least one, preferably a single, voltage level guard may advantageously be
provided, wherein the charge and discharge of the capacitor or
accumulator is controlled by use of the voltage level guard. As a result,
there is no need for any implanted current detector and/or charge level
detector for the control of the capacitor, which makes the apparatus
simple and reliable.
[0023] In a particular embodiment of the invention, the wireless energy of
the first form comprises sound waves and the energy of the second form
comprises electric energy, wherein the energy transforming device is
adapted to directly transform the sound waves into electric energy.
[0024] The apparatus may comprise an implantable motor or pump for
operating the restriction device, wherein the motor or pump is powered by
the transformed energy.
[0025] In accordance with a main aspect of the invention, the energy
transmission device may be adapted to transmit wireless energy for direct
use in connection with the operation of the restriction device, as the
wireless energy is being transmitted. The advantage of directly using
energy as it is transmitted is that the apparatus can be of a very simple
design and the few components involved makes the apparatus extremely
reliable. For example, the energy transmission device may be adapted to
directly power the motor or pump with wireless energy. The wireless
energy may comprise a magnetic field or electromagnetic waves, suitably
in the form of a signal, for direct power of the motor or pump. All the
various functions of the motor and associated components described in the
present specification may be used where applicable.
[0026] As an alternative to the above-noted main aspect of the invention,
the energy transforming device may be adapted to supply the energy of the
second form for direct use in connection with the operation of the
restriction device, as the energy of the first form is being transformed
into the energy of the second form. Consequently, the energy transforming
device may be adapted to directly power the motor or pump with the energy
of the second form.
[0027] Generally, the energy transforming device directly operates the
restriction device with the energy of the second form in a non-magnetic,
non-thermal or non-mechanical manner.
[0028] Where the apparatus comprises a motor, which may be adapted to
directly or intermittently operate the restriction device, the energy
transforming device may power the motor with the energy of the second
form. Suitably, the restriction device is operable to perform a
reversible function and the motor is capable of reversing said function.
[0029] In accordance with another embodiment of the invention, the
restriction device comprises a hydraulic restriction device, and the
apparatus comprises an implantable pump for operating the hydraulic
restriction device, wherein the energy transforming device supplies the
energy of the second form for driving the pump. Preferably, the pump is
not a plunger type of pump, but may comprise a peristaltic or membrane
pump.
[0030] The energy transforming device preferably is capable of generating
as the energy of the second form a current exceeding 1 .mu.A, when
transferring the energy of the first form transmitted by the energy
transmission device.
[0031] The apparatus may comprise an implantable adjustment device for
adjusting the restriction device to change the restriction of the faecal
passageway. In accordance with a first alternative the adjustment device
is adapted to mechanically adjust the restriction device. In accordance
with a second alternative the adjustment device is adapted to
hydraulically adjust the restriction device by using implanted hydraulic
means. Such hydraulic means may not use hydraulic fluid of the kind
having a viscosity that substantially increases when exposed to heat or a
magnetic field.
[0032] The apparatus of the present invention is not limited to the use of
visible light for the wireless transmission of energy. Thus, in
accordance with a broad aspect of the invention, the energy transmission
device transmits energy by at least one wireless signal, preferably
containing radiant energy.
[0033] The wireless signal may comprises a wave signal, for example an
electromagnetic wave signal, such as an infrared light signal, a visible
light signal, an ultra violet light signal, a laser signal, a micro wave
signal, a radio wave signal, an x-ray radiation signal, and a gamma
radiation signal. Where applicable, one or more of the above signals may
be combined. Alternatively, the wave signal may comprise a sound wave
signal, such as an ultrasonic signal. Generally, the wireless signal may
comprise a digital, analog or a digital and analog signal.
[0034] The energy of the first form transmitted by the energy transmission
device may comprise an electric or magnetic field transmitted in pulses,
for example digital pulses. Furthermore, the energy transforming device
may transform the energy of the first form, which may comprise polarised
energy, into a direct current, pulsating direct current, a combination of
a direct and pulsating direct current, an alternating current or a
combination of a direct and alternating current. Alternatively, the
energy of the first form may comprise kinetic energy.
[0035] The energy of the second form may comprise a frequency, amplitude
or frequency and amplitude modulated analog, digital or combined analog
and digital signal.
[0036] The restriction device may be non-inflatable, i.e. with no
hydraulic fluid involved for the adjustments of the restriction device.
This eliminates problems with fluid leaking from the restriction device.
[0037] The apparatus suitably comprises implantable electric conductors
connected to the energy transforming device, whereby the energy
transforming device is capable of supplying an electric current, such as
direct current, a pulsating direct current, a combination of a direct and
pulsating direct current, an alternating current or a combination of a
direct and alternating current, via the conductors. Furthermore, the
energy transforming device may be capable of supplying a frequency,
amplitude, or frequency and amplitude modulated analog, digital, or a
combination of analog and digital signal, which is used in connection
with control of the restriction device.
[0038] In accordance with a main embodiment of the invention, the
apparatus comprises an implantable operation device for operating the
restriction device and a control device for controlling the operation
device, wherein the energy transforming device powers the operation
device with the energy of the second form. The operation device
preferably comprises a motor, for example an electric linear motor or an
electric rotary motor that is controlled by the control device to rotate
a desired number of revolutions. Optionally, an implantable gearing may
be connected to the motor. The electric motor may have electrically
conductive parts made of plastics. Alternatively, the motor may comprise
a hydraulic or pneumatic fluid motor, wherein the control device controls
the fluid flow through the fluid motor. Motors currently available on the
market are getting smaller and smaller. Furthermore, there is a great
variety of control methods and miniaturised control equipment available.
For example, the number of revolutions of a rotary motor may be analysed
by a Hall-element just a few mm in size.
[0039] In accordance with another embodiment of the invention, the
restriction device comprises hydraulic means and the operation device is
adapted to conduct a hydraulic fluid in the hydraulic means. The
operation device comprises a fluid conduit connected to the hydraulic
means of the restriction device, and a reservoir for fluid, wherein the
reservoir forms part of the conduit. The reservoir may form a fluid
chamber with a variable volume, and the operation device may be adapted
to distribute fluid from the chamber to the hydraulic means of the
restriction device by reduction of the volume of the chamber and to
withdraw fluid from the hydraulic means to the chamber by expansion of
the volume of the chamber. The operation device suitably comprises an
implantable motor used for reducing and expanding the volume of the
chamber. Also, the operation device may comprise a pump for pumping the
hydraulic fluid in the hydraulic means of the restriction device. All of
the hydraulic components involved are preferably devoid of any non-return
valve. This is of great advantage, because with valves involved there is
always a risk of malfunction due to improperly working valves, especially
when long time periods passes between valve operations.
[0040] The control device may be adapted to reverse the operation device
by shifting polarity of the energy of the second form. Where the
operation device comprises an electric motor the energy of the second
form suitably comprises electric energy.
[0041] In accordance with yet another embodiment of the invention, the
restriction device is operable to perform a reversible function, such as
enlarging and restricting the blood flow passageway, and there is a
reversing device implanted in the patient for reversing the function
performed by the restriction device. Such a reversing function preferably
involves enlarging and restricting the blood flow passageway by the
restriction device, suitably in a stepless manner. In this connection,
the control device suitably controls the reversing device, which may
include a switch, to reverse the function performed by the restriction
device. The reversing device may comprise hydraulic means including a
valve for shifting the flow direction of a fluid in the hydraulic means.
Alternatively, the reversing device may comprise a mechanical reversing
device, such as a switch or a gearbox.
[0042] Where the reversing device comprises a switch it may be operable by
the energy of the second form. In this case, the control device suitably
controls the operation of the switch by shifting polarity of the energy
of the second form supplied to the switch. The switch may comprise an
electric switch and the source of energy may supply electric energy for
the operation of the switch.
[0043] In accordance with an advantageous embodiment of the invention, the
apparatus further comprises an energy storage device implanted in the
patient for storing the energy of the second form and for supplying
energy in connection with the operation of the restriction device. The
implanted energy storage device preferably comprises an electric source
of energy, such as an accumulator, a rechargeable battery or a
combination of an accumulator and rechargeable battery.
[0044] The apparatus may further comprise a switch implantable in the
patient for switching the operation of the restriction device and a
source of energy implantable in the patient. This embodiment is
particularly suited for applications where the energy transmission
efficiency of the apparatus is insufficient, i.e. where the implanted
restriction device is to perform more advanced operations. Such a source
of energy preferably is a battery. Alternatively, the source of energy is
an accumulator that also may store the energy of the second form.
[0045] In accordance with a first alternative, the switch is operated by
the energy of the second form supplied by the energy storage device to
switch from an off mode, in which the source of energy is not in use, to
an on mode, in which the source of energy supplies energy for the
operation of the restriction device. In this case, the implanted source
of energy may comprise a battery, preferably having a lifetime of at
least 10 years, or an accumulator. However, other kinds of sources are
also conceivable, such as a nuclear source of energy or a chemical source
of energy (fuel cells).
[0046] In accordance with a second alternative, the apparatus further
comprises a remote control for controlling the supply of energy of the
implanted source of energy, wherein the switch is operated by the energy
of the second form supplied by the energy storage device to switch from
an off mode, in which the remote control is prevented from controlling
the source of energy and the source of energy is not in use, to a standby
mode, in which the remote control is permitted to control the source of
energy to supply energy for the operation of the restriction device.
[0047] In accordance with a third alternative, the energy storage device
is omitted, wherein the switch is operated by the energy of the second
form supplied by the energy transforming device to switch from an off
mode, in which the remote control is prevented from controlling the
source of energy and the source of energy is not in use, to a standby
mode, in which the remote control is permitted to control the source of
energy to supply energy for the operation of the restriction device.
[0048] In accordance with a fourth alternative, also the remote control is
omitted, wherein the switch is operated by the energy of the second form
supplied by the energy transforming device to switch from an off mode, in
which the source of energy is not in use, to an on mode, in which the
source of energy supplies energy for the operation of the restriction
device. Where applicable, in the described embodiments the switch may
switch when the energy transmission device is transmitting wireless
energy, preferably while the transferred energy of the second form is
stabilised by an implanted capacitor, which may temporarily (for a few
seconds) store the energy of the second form.
[0049] In the above noted third and fourth alternatives, the energy
transmission device may be substituted for the energy transforming
device, whereby the switch is operated by the energy of the first form.
[0050] The switch mentioned above may comprise an electronic switch or,
where applicable, a mechanical switch.
[0051] The advantage of using a switch above all is increased control
safety; i.e. interfering signals in the patient's surroundings cannot
affect the implanted restriction device. Furthermore, the lifetime of the
implanted source of energy will be significantly prolonged, since the
energy consumption of the apparatus will be reduced to a minimum. During
the above-mentioned standby mode, the remote control uses energy from the
implanted source of energy. By means of the energy transmission device
energy may be transmitted to activate the switch to connect the implanted
source of energy only when energy is required in connection with the
operation of the restriction device.
[0052] All of the above embodiments may be combined with at least one
implantable sensor for sensing at least one physical parameter of the
patient, wherein the control device may control the restriction device in
response to signals from the sensor. Advantageously, the sensor may sense
ejaculation, and the restriction device may release said tissue portion
in response to the sensor sensing ejaculation.
[0053] The control device may comprise an internal control unit
implantable in the patient for, preferably directly, controlling the
restriction device in response to signals from the sensor. In response to
signals from the sensor, for example signals related to pressure, the
patient's position or any other important physical parameter, the
internal control unit may send information thereon to outside the
patient's body. The control device may also automatically control the
restriction device in response to signals from the sensor. For example,
the control device may control the restriction device to further restrict
the blood flow passageway in response to the sensor sensing that the
patients blood flow and blood pressure are increasing, or enlarge the
blood flow passageway in response to the sensor sensing an abnormally
high pressure against the restriction device or sensing ejaculation.
[0054] Alternatively, the control device may comprise an external control
unit outside the patient's body for, suitably directly, controlling the
restriction device in response to signals from the sensor. The external
control unit may store information on the physical parameter sensed by
the sensor and may be manually operated to control the restriction device
based on the stored information. In addition, there may be at least one
implantable sender for sending information on the physical parameter
sensed by the sensor.
[0055] An external data communicator may be provided outside the patient's
body and an internal data communicator may be implanted in the patient
for communicating with the external communicator. The internal
communicator may feed data related to the patient, or related to the
restriction device, back to the external communicator. Alternatively or
in combination, the external communicator may feed data to the internal
communicator. The internal communicator may suitably feed data related to
at least one physical signal of the patient.
[0056] The apparatus may further comprise an implantable programmable
control unit for controlling the restriction device, preferably over time
in accordance with an activity schedule program. This will advance the
apparatus and make possible an adaptation of the apparatus to the
individual patients.
[0057] Many of the above embodiments are suitably remote controlled. Thus,
the apparatus advantageously comprises a wireless remote control
transmitting at least one wireless control signal for controlling the
restriction device. With such a remote control it will be possible to
adapt the function of the apparatus to the patient's need. The control
signal may comprise a frequency, amplitude or frequency or amplitude
modulated signal. Furthermore, the control signal may comprise an analog
or a digital signal, or a combination of an analog and digital signal.
[0058] The wireless remote control may be capable of obtaining information
on the condition of the implanted restriction device and of controlling
the restriction device in response to the information. Also, The remote
control may be capable of sending information related to the restriction
device from inside the patient's body to the outside thereof.
[0059] In a particular embodiment of the invention, the wireless remote
control comprises at least one external signal transmitter or transceiver
and at least one internal signal receiver or transceiver implantable in
the patient. In another particular embodiment of the invention, the
wireless remote control comprises at least one external signal receiver
or transceiver and at least one internal signal transmitter or
transceiver implantable in the patient.
[0060] The wireless remote control may transmit a carrier signal for
carrying the control signal, wherein the carrier signal is frequency,
amplitude or frequency and amplitude modulated. The carrier signal may
also comprise digital, analog or a combination of digital and analog
signals. Such signals may comprise wave signals. Also the control signal
used with the carrier signal may be frequency, amplitude or frequency and
amplitude modulated, and be digital, analog or combined digital and
analog.
[0061] The control signal may comprise a wave signal, for example, a sound
wave signal, such as an ultrasound wave signal, an electromagnetic wave
signal, such as an infrared light signal, a visible light signal, an
ultra violet light signal, a laser signal, a micro wave signal, a radio
wave signal, an x-ray radiation signal, or a gamma radiation signal.
Where applicable, two or more of the above signals may be combined.
[0062] The control signal may be digital or analog, and may comprise an
electric or magnetic field. Suitably, the wireless remote control may
transmit an electromagnetic carrier wave signal for carrying the digital
or analog control signal. For example, use of an analog carrier wave
signal carrying a digital control signal would give safe communication.
The control signal may be transmitted in pulses by the wireless remote
control.
[0063] The energy transmission device may function different from or
similar to the energy transforming device. For example, the energy
transmission and transforming devices function differently when the
energy transmission device comprises a coil used for transmitting the
energy of the first form and the energy transforming device comprises an
electrical junction element for transforming the transmitted energy into
the energy of the second form. The energy transmission and transforming
devices function similar to each other when the energy transmission
device comprises a coil used for transmitting the energy of the first
form and the energy transforming device also comprises a coil for
transforming the transmitted energy into the energy of the second form.
[0064] In accordance with an alternative embodiment of the invention, the
apparatus comprises an activatable source of energy implantable in the
patient, wherein the source of energy is activated by wireless energy
transmitted by the energy transmission device, to supply energy which is
used in connection with the operation of the restriction device.
[0065] The implantable restriction device suitably is embedded in a soft
or gel-like material. For example, a silicone material having hardness
less than 20 Shore.
[0066] All the above described various components, such as the motor, pump
and capacitor, may be combined in the different embodiments where
applicable. Also the various functions described in connection with the
above embodiments of the invention may be used in different applications,
where applicable.
[0067] All the various ways of transferring, transforming and controlling
energy presented in the present specification may be practised by using
all of the various components and solutions described.
[0068] The present invention also provides methods for implanting the
apparatus of the invention, and for treating impotence.
[0069] Accordingly, there is provided an implanting method, comprising the
steps of: providing an impotence treatment apparatus as described above,
cutting an opening in a patient's mucosa in the orifice of the patient's
body, and implanting the energy transforming means in the patient's body
through the opening. Alternatively, the cutting step may comprise cutting
the opening in the patient's skin and the implanting step may comprise
implanting the energy transforming means in the patient's body through
the opening.
[0070] There is also provided a laparascopical implanting method,
comprising the steps of: providing the impotence treatment apparatus as
desribed above, placing at least two laparascopic cannula within a
patient's body, and implanting the energy transforming means in the
patient's body by using the at least two laparascopic cannula.
[0071] In accordance with another alternative there is provided a
laparascopical surgical method of implanting the impotence treatment
apparatus, comprising the steps of: a) Providing the impotence treatment
apparatus as desribed above. b) Placing at least two laparoscopic trocars
within the patient's body. c) Using a dissecting tool inserted through
the laparoscopic trocars, dissecting the region of the penile tissue or
the prolongation thereof. d) Introducing the operable restriction device
of the apparatus through the trocars. e) Placing the restriction device
in engagement with the penile tissue or the prolongation thereof to
create a stoma through which blood flow leaves the penis. And f)
implanting the energy transforming means of the apparatus in the patient
for transforming wireless energy into energy of a form suited for
operating the restriction device to reduce the stoma to restrict the
blood flow therethrough. The method as recited in (a)-(f) may further
comprise adjusting the reduced stoma in a non-invasive procedure.
[0072] There is also provided a method of treating an impotent male
comprising: (a) Surgically implanting in a male patient a restriction
device engaging the male's penile tissue or the prolongation thereof to
form a restrictable passageway in which blood flow leaves the penis. (b)
Surgically implanting in the male the operation device which can adjust
the restricted passageway in response to supplied energy. And (c) in a
non-invasive post-operative procedure, from time to time, supplying
energy to the operation device so as to restrict the passageway to reduce
the blood flow leaving the male's penis to achieve erection. In the
method (c) may be practised by the patient whenever he desires.
[0073] The invention is described in more detail in the following with
reference to the accompanying drawings, in which
[0074] FIGS. 1 to 12 are schematic block diagrams illustrating twelve
embodiments, respectively, of the male sexual impotence treatment
apparatus of the invention, in which wireless energy is transmitted from
outside a patient's body to energy consuming components of the apparatus
implanted in the patient;
[0075] FIG. 13 is a schematic block diagram illustrating conceivable
combinations of implanted components for achieving various communication
options;
[0076] FIG. 14 illustrates an electrical junction element for use in the
apparatus of the present invention; and
[0077] FIG. 15 illustrates the apparatus in accordance with the invention
implanted in a patient.
[0078] FIG. 16 is a block diagram illustrating remote control components
of an embodiment of the invention, in which wireless energy is
transmitted by the use of electromagnetic signals; and
[0079] FIG. 17 is a schematic view of exemplary circuitry used for the
components of the block diagram of FIG. 16.
[0080] Referring to the drawing figures, like reference numerals designate
identical or corresponding elements throughout the several figures.
[0081] FIG. 1 schematically shows a very simple embodiment of the
impotence apparatus of the invention having some parts implanted in a
patient and other parts located outside the patient's body. Thus, in FIG.
1 all parts placed to the right of the patient's skin 2 are implanted and
all parts placed to the left of the skin 2 are located outside the
patient's body.
[0082] The apparatus of FIG. 1 comprises an implanted operable restriction
device 4, which engages penile tissue or the prolongation thereof to form
a restrictable passageway for blood flow leaving the penis. The
restriction device 4 is capable of performing a reversible function, i.e.
to enlarge and restrict the passageway, so that the restriction device 4
works as an artificial sphincter. The implanted energy transforming means
6 is adapted to supply energy consuming components of the restriction
device 4 with energy via a power supply line 12. The external energy
transmission means 10 includes a wireless remote control transmitting a
wireless signal which is received by a signal receiver incorporated in
the implanted energy transforming means 6. The implanted energy
transforming means 6 transforms energy from the signal into electric
energy which is supplied via the power supply line 12 to the restriction
device 4, which energy causes portions of the device 4 to move and thus
adjust the opening.
[0083] FIG. 2 shows an embodiment of the invention identical to that of
FIG. 1, except that a reversing device in the form of an electric switch
14 also is implanted in the patient for reversing the restriction device
4. The wireless remote control of the external energy transmission means
10 transmits a wireless signal that carries energy and the implanted
energy transforming means 6 transforms the wireless energy into a current
for operating the switch 14. When the polarity of the current is shifted
by the energy transforming means 6 the switch 14 reverses the function
performed by the restriction device 4.
[0084] FIG. 3 shows an embodiment of the invention identical to that of
FIG. 1, except that the operation device in the form of a motor 15 for
operating the restriction device 4 also is implanted in the patient. The
motor 15 is powered with energy from the energy transforming means 6, as
the remote control of the external energy transmission means 10 transmits
a wireless signal to the receiver of the energy transforming means 6.
[0085] FIG. 4 shows an embodiment of the invention identical to that of
FIG. 1, except that an assembly 16 including a motor/pump unit 18 and a
fluid reservoir 20 also is implanted in the patient. In this case the
restriction device 4 is hydraulically operated, i.e. hydraulic fluid is
pumped by the motor/pump unit 18 from the reservoir 20 through a conduit
22 to the restriction device 4 to restrict the passageway, and hydraulic
fluid is pumped by the motor/pump unit 18 back from the restriction
device 4 to the reservoir 20 to enlarge the cross-sectional area. The
implanted energy transforming means 6 transforms wireless energy into a
current, for powering the motor/pump unit 18 via the electric power
supply line 24.
[0086] FIG. 5 shows an embodiment of the invention comprising the external
energy transmission means 10 with its wireless remote control, the
restriction device 4, in this case hydraulically operated, and the
implanted energy transforming means 6, and further comprising an
implanted hydraulic fluid reservoir 30, an implanted motor/pump unit 32
and an implanted reversing device in the form of a hydraulic valve
shifting device 34. The motor of the motor/pump unit 32 is the electric
motor. In response to a control signal from the wireless remote control
of the external energy transmission means 10, the implanted energy
transforming means 6 powers the motor/pump unit 32 with energy from the
energy carried by the control signal, whereby the motor/pump unit 32
distributes hydraulic fluid between the reservoir 30 and the restriction
device 4. The remote control of the energy transmission means 10 controls
the shifting device 34 to shift the hydraulic fluid flow direction
between one direction in which the fluid is pumped by the motor/pump unit
32 from the reservoir 30 to the restriction device 4 to reduce the
passageway, and another opposite direction in which the fluid is pumped
by the motor/pump unit 32 back from the restriction device 4 to the
reservoir 30 to enlarge the cross-sectional area.
[0087] FIG. 6 shows an embodiment of the invention identical to that of
FIG. 1, except that a control unit 36 controlled by the wireless remote
control of the external energy transmission means 10, an accumulator 38
and a capacitor 40 also are implanted in the patient. The control unit 36
stores electric energy received from the energy transforming means 6 in
the accumulator 38, which supplies energy to the restriction device 4. In
response to a control signal from the wireless remote control of the
energy transmission means 10, the control unit 6 either releases electric
energy from the accumulator 38 and transfers the released energy via
power lines 42 and 44, or directly transfers electric energy from the
energy transforming means 6 via a power line 46, the capacitor 40, which
stabilises the electric current, a power line 48 and the power line 44,
for the operation of the restriction device 4.
[0088] In accordance with one alternative, the capacitor 40 in the
embodiment of FIG. 6 may be omitted. In accordance with another
alternative, the accumulator 38 in this embodiment may be omitted.
[0089] FIG. 7 shows an embodiment of the invention identical to that of
FIG. 1, except that a battery 50 for supplying energy for the operation
of the restriction device 4 and an electric switch 52 for switching the
operation of the restriction device 4 also are implanted in the patient.
The switch 52 is operated by the energy supplied by the energy
transforming means 6 to switch from an off mode, in which the battery 50
is not in use, to an on mode, in which the battery 50 supplies energy for
the operation of the restriction device 4.
[0090] FIG. 8 shows an embodiment of the invention identical to that of
FIG. 7, except that a control unit 36 controllable by the wireless remote
control of the external energy transmission means 10 also is implanted in
the patient. In this case, the switch 52 is operated by the energy
supplied by the energy transforming means 6 to switch from an off mode,
in which the wireless remote control is prevented from controlling the
control unit 36 and the battery 50 is not in use, to a standby mode, in
which the remote control is permitted to control the control unit 36 to
release electric energy from the battery 50 for the operation of the
restriction device 4.
[0091] FIG. 9 shows an embodiment of the invention identical to that of
FIG. 8, except that the accumulator 38 is substituted for the battery 50
and the implanted components are interconnected differently. In this
case, the accumulator 38 stores energy from the energy transforming means
6. In response to a control signal from the wireless remote control of
the external energy transmission means 10, the implanted control unit 36
controls the switch 52 to switch from an off mode, in which the
accumulator 38 is not in use, to an on mode, in which the accumulator 38
supplies energy for the operation of the restriction device 4.
[0092] FIG. 10 shows an embodiment of the invention identical to that of
FIG. 9, except that the battery 50 also is implanted in the patient and
the implanted components are interconnected differently. In response to a
control signal from the wireless remote control of the external energy
transmission means 10, the implanted control unit 36 controls the
accumulator 38 to deliver energy for operating the switch 52 to switch
from an off mode, in which the battery 50 is not in use, to an on mode,
in which the battery 50 supplies electric energy for the operation of the
restriction device 4.
[0093] Alternatively, the switch 52 may be operated by energy supplied by
the accumulator 38 to switch from an off mode, in which the wireless
remote control is prevented from controlling the battery 50 to supply
electric energy and the battery 50 is not in use, to a standby mode, in
which the wireless remote control is permitted to control the battery 50
to supply electric energy for the operation of the restriction device 4.
[0094] FIG. 11 shows an embodiment of the invention identical to that of
FIG. 7, except that a motor 15, a mechanical reversing device in the form
of a gearbox 54 and a control unit 36 for controlling the gearbox 54 also
are implanted in the patient. The implanted control unit 36 controls the
gearbox 54 to reverse the function performed by the restriction device 4
(mechanically operated).
[0095] FIG. 12 shows an embodiment of the invention identical to that of
FIG. 10 except that the implanted components are interconnected
differently. Thus, in this case the battery 50 powers the control unit 36
when the accumulator 38, suitably a capacitor, activates the switch 52 to
switch to an on mode. When the switch 52 is in its on mode the control
unit 36 is permitted to control the battery 50 to supply, or not supply,
energy for the operation of the restriction device 4.
[0096] FIG. 13 schematically shows conceivable combinations of implanted
components of the apparatus for achieving various communication options.
Basically, there are the implanted restriction device 4, control unit 36
and motor/pump unit 18, and the external energy transmission means 10
including the external wireless remote control. As already described
above the wireless remote control transmits a control signal which is
received by the implanted control unit 36, which in turn controls the
various implanted components of the apparatus.
[0097] A sensor 56 may be implanted in the patient for sensing a physical
parameter of the patient, such as the pressure in the passageway. The
implanted control unit 36, or alternatively the external wireless remote
control of the energy transmission means 10, may control the restriction
device 4 in response to signals from the sensor 56. A transceiver may be
combined with the sensor 56 for sending information on the sensed
physical parameter to the external wireless remote control. The wireless
remote control may comprise a signal transmitter or transceiver and the
implanted control unit 36 may comprise a signal receiver or transceiver.
Alternatively, the wireless remote control may comprise a signal receiver
or transceiver and the implanted control unit 36 may comprise a signal
transmitter or transceiver. The above transceivers, transmitters and
receivers may be used for sending information or data related to the
restriction device 4 from inside the patient's body to the outside
thereof.
[0098] Where the motor/pump unit 18 and battery 50 for powering the
motor/pump unit 18 are implanted, the battery 50 may be equipped with a
transceiver for sending information on the condition of the battery 50.
[0099] Those skilled in the art will realise that the above various
embodiments according to FIGS. 1-13 could be combined in many different
ways. For example, the energy operated switch 14 could be incorporated in
any of the embodiments of FIGS. 3,6-12, the hydraulic shifting device 34
could be incorporated in the embodiment of FIG. 4, and the gearbox 54
could be incorporated in the embodiment of FIG. 3.
[0100] FIG. 14 shows the energy transforming means in the form of an
electrical junction element 58 for use in any of the above embodiments
according to FIGS. 1-13. The element 58 is a flat p-n junction element
comprising a p-type semiconductor layer 60 and an n-type semiconductor
layer 62 sandwiched together. A light
bulb 64 is electrically connected
to opposite sides of the element 58 to illustrate how the generated
current is obtained. The output of current from such a p-n junction
element 58 is correlated to the temperature. See the formula below.
I=I0(exp(qV/kT)-1)
[0101] where
[0102] I is the external current flow,
[0103] I0 is the reverse saturation current,
[0104] q is the fundamental electronic charge of 1.602.times.10-19
coulombs,
[0105] V is the applied voltage,
[0106] k is the Boltzmann constant, and
[0107] T is the absolute temperature.
[0108] Under large negative applied voltage (reverse bias), the
exponential term becomes negligible compared to 1.0, and I is
approximately -I0. I0 is strongly dependent on the temperature of the
junction and hence on the intrinsic-carrier concentration. I0 is larger
for materials with smaller bandgaps than for those with larger bandgaps.
The rectifier action of the diode, that is, its restriction of current
flow to only one direction, is in this particular embodiment the key to
the operation of the p-n junction element 58.
[0109] The alternative way to design a p-n junction element is to deposit
a thin layer of semiconductor onto a supporting material which does not
absorb the kind of energy utilised in the respective embodiments. For use
with wirelessly transmitted energy in terms of light waves, glass could
be a suitable material. Various materials may be used in the
semiconductor layers such as but not limited to cadmium telluride,
copper-indium-diselenide and silicon. It is also possible to use a
multilayer structure with several layers of p and n-type materials to
improve efficiency.
[0110] The electric energy generated by the p-n junction element 58 could
be of the same type as generated by solar cells, in which the negative
and positive fields create a direct current. Alternatively, the negative
and positive semiconductor layers may change polarity following the
transmitted waves, thereby generating the alternating current.
[0111] The p-n junction element 58 is designed to make it suited for
implantation. Thus, all the external surfaces of the element 58 in
contact with the human body are made of a biocompatible material. The p-n
junction semiconductors are designed to operate optimally at a body
temperature of 37.degree. C. because the current output, which should be
more than 1 .mu.A, is significantly depending on temperature as shown
above. Since both the skin and subcutis absorb energy, the relation
between the sensitivity or working area of the element 58 and the
intensity or strength of the wireless energy transmission is considered.
The p-n junction element 58 preferably is designed flat and small.
Alternatively, if the element 58 is made in larger sizes it should be
flexible, in order to adapt to the patient's body movements. The volume
of the element 58 should be kept less than 2000 cm.sup.3.
[0112] FIG. 15 generally illustrates how any of the above-described
embodiments of the impotence treatment apparatus of the invention may be
implanted in a male patient. Thus, a restriction device 4 implanted in a
patient engages penile tissue or the prolongation thereof to form an
artificial sphincter around the passageway through which the blood flow
leaves the penis. An implanted operation device 68, which may also be
referred to as an adjustment device, such as an electric motor or a
motor/pump assembly, operates the restriction device 4 through a
transmission member 70, such as a mechanical transmission cord or a fluid
tube. The energy transforming means in the form of the element 6 having a
positive region and a negative region, as described above in more detail,
is placed underneath the skin of the patient. The external energy
transmission means 10 is adapted to transmit wireless energy to the
implanted element 6. A wireless remote control includes an external
control unit incorporated in the energy transmission means 10, and an
implanted control unit 71 connected to the element 6 and the operation
device 68.
[0113] Wireless energy carried by a signal transmitted by the wireless
remote control of the external energy transmission means 10 at least
partly penetrates the patient's skin and hits the element 6. The energy
thus hitting the element 6 is transformed into energy of a different form
that is suited for powering the operation device 68. For example, where
the operation device 68 is an electric motor the element 6 comprises an
electric p-n junction element that transforms the wireless energy into an
electric current for powering the electric motor. Where the operation
device 68 comprises a pump, the element 6 may transform the wireless
energy into kinetic energy for powering the pump.
[0114] The transformed energy may be utilised for directly operating the
restriction device 4 or, where the restriction device 4 is electrically
operated, for storage in a capacitor and/or an accumulator for later or
parallel use. Preferably (but not necessarily) the element 6 is
controlled by a microprocessor. The wireless remote control of the
external energy transmission means 10 is used to control the utilisation
of the transmitted energy and any function or command to/from the
implanted restriction device 4.
[0115] FIG. 16 shows the basic parts of a wireless remote control of the
apparatus of the invention including an electric motor 128 for operating
a restriction member, for example of the type illustrated in FIG. 15. In
this case, the remote control is based on the transmission of
electromagnetic wave signals, often of high frequencies in the order of
100 kHz-1 gHz, through the skin 130 of the patient. In FIG. 15, all parts
placed to the left of the skin 130 are located outside the patient's body
and all parts placed to the right of the skin 130 are implanted. Any
suitable remote control system may be used.
[0116] An external signal transmitting antenna 132 is to be positioned
close to a signal receiving antenna 134 implanted close to the skin 130.
As an alternative, the receiving antenna 134 may be placed for example
inside the abdomen of the patient. The receiving antenna 134 comprises a
coil, approximately 1-100 mm, preferably 25 mm in diameter, wound with a
very thin wire and tuned with a capacitor to a specific high frequency. A
small coil is chosen if it is to be implanted under the skin of the
patient and a large coil is chosen if it is to be implanted in the
abdomen of the patient. The transmitting antenna 132 comprises a coil
having about the same size as the coil of the receiving antenna 134 but
wound with a thick wire that can handle the larger currents that is
necessary. The coil of the transmitting antenna 132 is tuned to the same
specific high frequency as the coil of the receiving antenna 134.
[0117] An external control unit 136 comprises a microprocessor, a high
frequency electromagnetic wave signal generator and a power amplifier.
The microprocessor of the control unit 136 is adapted to switch the
generator on/off and to modulate signals generated by the generator to
send digital information via the power amplifier and the antennas 132,134
to an implanted control unit 138. To avoid that accidental random high
frequency fields trigger control commands, digital signal codes are used.
A conventional keypad placed on the external control unit 136 is
connected to the microprocessor thereof. The keypad is used to order the
microprocessor to send digital signals to either contract or enlarge the
restriction device. The microprocessor starts a command by applying a
high frequency signal on the antenna 132. After a short time, when the
signal has energised the implanted parts of the control system, commands
are sent to contract or enlarge the restriction device in predefined
steps. The commands are sent as digital packets in the form illustrated
below.
1
Start pattern, Command, Count, Checksum,
8
bits 8 bits 8 bits 8 bits
[0118] The commands are sent continuously during a rather long time period
(e.g. about 30 seconds or more). When a new contract or enlarge step is
desired the Count byte is increased by one to allow the implanted control
unit 138 to decode and understand that another step is demanded by the
external control unit 136. If any part of the digital packet is
erroneous, its content is simply ignored.
[0119] Through a line 140, an implanted energiser unit 126 draws energy
from the high frequency electromagnetic wave signals received by the
receiving antenna 134. The energiser unit 126 stores the energy in an
energy storage device, such as a large capacitor, powers the control unit
138 and powers the electric motor 128 via a line 142.
[0120] The control unit 138 comprises a demodulator and a microprocessor.
The demodulator demodulates digital signals sent from the external
control unit 136. The microprocessor of the control unit 138 receives the
digital packet, decodes it and, provided that the power supply of the
energiser unit 126 has sufficient energy stored, sends a signal via a
signal line 144 to the motor 128 to either contract or enlarge the
restriction device depending on the received command code.
[0121] Alternatively, the energy stored in the energy storage device of
the energiser unit may only be used for powering a switch, and the energy
for powering the motor 128 may be obtained from another implanted energy
source of relatively high capacity, for example a battery. In this case
the switch is adapted to connect said battery to the control unit 138 in
an on mode when said switch is powered by the energy storage device and
to keep the battery disconnected from the control unit in a standby mode
when the switch is not powered.
[0122] With reference to FIG. 17, the remote control schematically
described above will now be described in accordance with a more detailed
embodiment. The external control unit 136 comprises a microprocessor 146,
a signal generator 148 and a power amplifier 150 connected thereto. The
microprocessor 146 is adapted to switch the signal generator 148 on/off
and to modulate signals generated by the signal generator 148 with
digital commands that are sent to implanted components of the apparatus.
The power amplifier 150 amplifies the signals and sends them to the
external signal transmitting antenna 132. The antenna 132 is connected in
parallel with a capacitor 152 to form a resonant circuit tuned to the
frequency generated by the signal generator 148.
[0123] The implanted signal receiving antenna coil 134 forms together with
a capacitor 154 a resonant circuit that is tuned to the same frequency as
the transmitting antenna 132. The signal receiving antenna coil 134
induces a current from the received high frequency electromagnetic waves
and a rectifying diode 160 rectifies the induced current, which charges a
storage capacitor 158. A coil 156 connected between the antenna coil 134
and the diode 160 prevents the capacitor 158 and the diode 160 from
loading the circuit of the signal receiving antenna 134 at higher
frequencies. Thus, the coil 156 makes it possible to charge the capacitor
158 and to transmit digital information using amplitude modulation.
[0124] A capacitor 162 and a resistor 164 connected in parallel and a
diode 166 forms a detector used to detect amplitude modulated digital
information. A filter circuit is formed by a resistor 168 connected in
series with a resistor 170 connected in series with a capacitor 172
connected in series with the resistor 168 via ground, and a capacitor
174, one terminal of which is connected between the resistors 168,170 and
the other terminal of which is connected between the diode 166 and the
circuit formed by the capacitor 162 and resistor 164. The filter circuit
is used to filter out undesired low and high frequencies. The detected
and filtered signals are fed to an implanted microprocessor 176 that
decodes the digital information and controls the motor 128 via an
H-bridge 178 comprising transistors 180,182,184 and 186. The motor 128
can be driven in two opposite directions by the H-bridge 178.
[0125] The microprocessor 176 also monitors the amount of stored energy in
the storage capacitor 158. Before sending signals to activate the motor
128, the microprocessor 176 checks whether the energy stored in the
storage capacitor 158 is enough. If the stored energy is not enough to
perform the requested operation, the microprocessor 176 waits for the
received signals to charge the storage capacitor 158 before activating
the motor 128.
* * * * *