JP2014076162A - Bladder indwelling catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a bladder indwelling catheter that is capable of supplying a liquid chemical to a prescribed region in a bladder in a state of indwelling its tip in the bladder.SOLUTION: A balloon 8 to be expanded in a bladder is placed at a neighborhood of a tip of a catheter body 1, and a liquid chemical flow passage 15 circulates a liquid chemical, which is sent to the neighborhood of the tip of the catheter body 1, along a surface of the expanded balloon 8, and then, at least one liquid chemical discharge port 16 placed at a prescribed position according to the expansion of the balloon 8 discharges the liquid chemical circulating through the liquid chemical flow passage 15 into the bladder.

Description

  The present invention relates to a bladder indwelling catheter, and more particularly to a bladder indwelling catheter in which a distal end is placed in the bladder by expanding a balloon disposed in the vicinity of the distal end in the bladder.

2. Description of the Related Art Conventionally, in the medical field, for example, a bladder indwelling catheter for discharging urine and blood accumulated in the bladder has been used after surgery for excision of a bladder tumor or after surgery using general anesthesia. The indwelling catheter is inserted into the bladder via the urethra, and then a balloon disposed in the vicinity of the distal end is expanded in the bladder so that the distal end is placed in the bladder. The By disposing the distal end of the bladder indwelling catheter in the bladder, urine collected in the bladder is discharged out of the body through a urine drainage passage extending from the urine drainage hole formed near the distal end to the proximal end. To do.
Thus, by placing the bladder indwelling catheter in the bladder, urine or the like accumulated in the bladder can be automatically drained over a long period of time.

  In recent years, indwelling bladder catheters are also used for the purpose of treating diseases such as the urethra. For example, Patent Document 1 discloses a bladder indwelling catheter having a fluid reservoir to which heated fluid is supplied at an intermediate portion. In this indwelling catheter, the fluid reservoir is designed to be located in the urethra when the distal end portion is indwelled in the bladder. By supplying heated fluid into the fluid reservoir, Can relieve symptoms such as chronic pelvic pain syndrome. Further, the indwelling catheter has a fluid supply port for supplying heated fluid into the bladder in the vicinity of the distal end, and by supplying heated fluid to warm the bladder tissue, urinary tract disease The symptoms of can be further alleviated.

Japanese Patent No. 4602322

Thus, the bladder indwelling catheter is used for a wide range of purposes, such as urine excretion after surgery and disease treatment. However, there is a problem that when the bladder indwelling catheter is placed, the bladder is stimulated and the patient feels uncomfortable frequently. Generally, after the aforementioned operation, the bladder indwelling catheter is indwelled for a long period of time ranging from several hours to 30 days, so that the patient feels uncomfortable for a long period of time.
Discomfort caused by the placement of the bladder indwelling catheter has been observed to be similar to overactive bladder (OAB) such as frequent urination, urgency, urinary incontinence and pain. Currently, methods for alleviating symptoms of overactive bladder include, for example, oral administration of anticholinergic drugs, β3 adrenergic receptor agonists, α1 adrenergic blockers, smooth muscle relaxants and tricyclic antidepressants, resinifera Toxic bladder administration or botulinum toxin intravesical administration is known. However, in these methods, the present situation is that the discomfort caused by the placement of the bladder indwelling catheter cannot be greatly improved.
Here, in the bladder B shown in FIG. 15, there are almost no autonomic nerves in the lamina propria of the bladder bottom and the lower wall, while sensory nerves increase as approaching the internal urethral orifice I, and in the vicinity of the bladder triangle T Numerous sensory nerves gather to form a plexus. When the distal end of the bladder indwelling catheter is placed in the bladder, the expanded balloon is positioned near the bladder triangle T. For discomfort caused by the placement of the bladder indwelling catheter, the balloon or the like is placed in the bladder triangle T. It is thought that contact is greatly involved.
For this reason, when a bladder indwelling catheter is placed, the discomfort of the patient is greatly reduced by intensively administering a local anesthetic or a drug used in the treatment of overactive bladder to the bladder triangle T of the bladder B It is considered possible. However, for example, in the bladder indwelling catheter described in Patent Document 1, a fluid supply port is formed in the catheter body, and the drug is administered to a predetermined region in the bladder B even if the drug is released from the fluid supply port. It is difficult to effectively administer the drug to the bladder triangle T that spreads in the vicinity of the internal urethral orifice I of the bladder B.

  The present invention has been made to solve such a conventional problem, and provides a bladder indwelling catheter capable of supplying a drug to a predetermined region in the bladder in a state where the distal end portion is indwelled in the bladder. The purpose is to do.

  A bladder indwelling catheter according to the present invention is a bladder indwelling catheter in which an expansion balloon for expanding in the bladder is disposed in the vicinity of the distal end portion of the catheter body, and the catheter body extends from the vicinity of the distal end portion to the proximal end portion. A chemical solution feeding path for delivering the chemical solution to the vicinity of the distal end portion, and communicates with the chemical solution feeding path in the vicinity of the distal end portion of the catheter main body along the expanded balloon surface. The medicinal solution flow passage for circulating the medicinal solution and the at least one medicinal solution discharge port that is arranged at a predetermined position according to the expansion of the balloon for expansion and discharges the medicinal solution flowing through the medicinal solution flow passage into the bladder A discharge part is provided.

  Here, the expansion balloon is expanded so as to cover the bladder triangular portion of the bladder, and the drug solution discharge port is formed to be disposed in the vicinity of the bladder triangular portion according to the expansion of the expansion balloon. Is preferred.

Moreover, the said chemical | medical solution discharge port can be formed from the through-hole which has a circular shape or a slit shape. The chemical solution discharge port may be configured by covering the through hole with a mesh material.
Further, the chemical solution discharge port may be formed of a film material having a plurality of holes having a size of 1 nm to 10 μm. The membrane material can be composed of a porous membrane or a dialysis membrane. In addition, the chemical solution discharge port may be formed by arranging the continuous membrane material or a plurality of the membrane materials so as to surround the periphery of the expansion balloon.

In addition, the drug solution discharge portion is configured by a drug solution discharge balloon surrounding the entire circumference of the dilatation balloon so as to form a double balloon with the dilatation balloon, and the drug solution flow path is formed by the dilation balloon. It can be formed between the surface of the balloon and the inner surface of the drug solution releasing balloon.
Moreover, the said chemical | medical solution discharge | release part can also be comprised along the one part surface of the said balloon for expansion | swelling. The drug solution discharge part is composed of a tube having a side part bonded to the surface of the balloon for expansion, and one end thereof communicates with the drug solution feeding path of the catheter body and the drug solution discharge port is formed at the other end. be able to.

The catheter main body may have at least one urethral drug solution outlet for discharging the drug solution fed through the drug solution feeding path into the urethra.
Further, the catheter body further includes a urethral drug solution feeding path for feeding a drug solution extending from the base end portion to the intermediate portion, and the drug solution is communicated with the urethral drug solution feed path and the outside to communicate the drug solution. It is also possible to form at least one intraurethral drug outlet for release into the urethra.

  According to the present invention, since there is a drug solution discharge port that is arranged at a predetermined location according to the expansion of the balloon and discharges the drug solution flowing through the drug solution flow path along the surface of the balloon into the bladder, the distal end portion is placed on the bladder The medicine can be supplied to a predetermined region in the bladder while indwelling.

It is a figure which shows the structure of the bladder indwelling catheter which concerns on Embodiment 1 of this invention. FIG. 3 is a cross-sectional view showing a configuration in the vicinity of the distal end portion of the bladder indwelling catheter according to the first embodiment. FIG. 3 is a diagram showing a configuration in the vicinity of a distal end portion of the bladder indwelling catheter according to the first embodiment. It is a figure which shows the mode of the bladder indwelling catheter indwelled in the bladder in steps. FIG. 6 is a diagram showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to a modification example of the first embodiment. It is a figure which shows the structure of the front-end | tip part vicinity of the bladder indwelling catheter which concerns on Embodiment 2. FIG. FIG. 10 is a diagram showing a configuration near the distal end of a bladder indwelling catheter according to a modification of the second embodiment. FIG. 10 is a diagram showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to a third embodiment. FIG. 10 is a cross-sectional view showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to a third embodiment. FIG. 10 is a diagram showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to a modification example of the third embodiment. FIG. 10 is a diagram showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to another modification of the third embodiment. The structure of the chemical | medical solution discharge port which concerns on the further another modification of Embodiment 3 is shown, (A) is a top view, (B) is a cross-sectional view. FIG. 6 is a cross-sectional view showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to a fourth embodiment. FIG. 10 is a cross-sectional view showing a configuration in the vicinity of a distal end portion of a bladder indwelling catheter according to another modification of the fourth embodiment. It is a figure which shows the position of the bladder triangular part in a bladder.

Embodiments of the present invention will be described below with reference to the accompanying drawings.
Embodiment 1
FIG. 1 shows the configuration of a bladder indwelling catheter according to Embodiment 1 of the present invention. This bladder indwelling catheter has a catheter main body 1 and an expansion portion 2 disposed in the vicinity of the distal end portion of the catheter main body 1 so as to be expandable.

  The catheter main body 1 is inserted into the bladder through the urethra, and includes an elongated shaft 3 for discharging urine and the like accumulated in the bladder to the side near the tip. A urine discharge hole 4 is formed. Further, a urine discharge port 5 for discharging urine flowing from the urine discharge hole 4 to the outside of the body and an expansion liquid port for injecting an expansion liquid for expanding the expansion part 2 are provided at the base end of the shaft 3. 6 and a drug solution port 7 for injecting a drug solution for treating the bladder are disposed.

Here, the shaft 3 can be made of an elastic material, and can be made of, for example, a thermoplastic elastomer, latex (natural rubber), silicon, and synthetic rubber. Further, the injection of the expansion liquid from the expansion liquid port 6 and the injection of the chemical liquid from the chemical liquid port 7 can be performed using, for example, a syringe, an indeflator, and a syringe pump.
In addition, as the drug solution, those that relieve discomfort caused by placing a bladder indwelling catheter in the bladder can be used. For example, local anesthetics (ropivacaine hydrochloride, bupivacaine hydrochloride, lidocaine hydrochloride), anticholine Drugs (oxybutynin hydrochloride, tolterodine tartrate, propiverine hydrochloride), adrenergic receptor agonists (mirabegron), muscle relaxants (fulvoxate hydrochloride), anti-inflammatory agents (diclofenac sodium), and the like can be used. Moreover, a chemical | medical solution can be supplied as liquids, such as suspension, or can be supplied as gel states, such as a jelly and a viscous liquid. Further, as the expansion liquid, sterilized water, physiological saline, or the like can be used.

FIG. 2 shows a state in which the expansion portion 2 disposed in the vicinity of the distal end portion of the catheter body 1 is expanded. The expansion part 2 is configured to be a double balloon, and includes an expansion balloon 8 that is expanded in a spherical shape on the inside, and a drug release balloon that surrounds the entire circumference of the expansion balloon 8 and is disposed on the outside thereof. 9.
The expansion balloon 8 can be made of a material having expandability, and can be made of, for example, a thermoplastic elastomer, latex (natural rubber), silicon, and synthetic rubber. The drug release balloon 9 can be made of a material having expandability similar to the expansion balloon 8, but is used in the expansion balloon 8 so as to expand in accordance with the expansion of the expansion balloon 8. It is preferable that the material is the same as the material.

Inside the shaft 3, a urine discharge path 10 is formed that extends from the urine discharge hole 4 to the urine discharge port 5 and guides urine flowing from the urine discharge hole 4 to the urine discharge port 5. Further, the shaft 3 is formed with an expansion liquid outlet 11 for sending the expansion liquid to the inside of the expansion balloon 8 on the side near the tip, and from the expansion liquid port 6 to the expansion liquid outlet 11. An expansion liquid supply path 12 is formed in the expansion liquid supply path 12 for supplying the expansion liquid injected from the expansion liquid port 6 to the expansion liquid outlet 11. By supplying the expansion liquid injected from the expansion port 6 into the expansion balloon 8 from the expansion liquid delivery port 11, the expansion balloon 8 can be expanded larger than the inner urethral opening in the bladder.
Further, the shaft 3 is formed with a chemical solution delivery port 13 for sending the chemical solution between the expansion balloon 8 and the chemical solution discharge balloon 9 on the side near the distal end, and from the chemical solution port 7 to the chemical solution. A chemical liquid supply path 14 is formed inside the chemical liquid supply path 14 for supplying the chemical liquid injected from the chemical liquid port 7 to the chemical liquid outlet 13. Here, the drug solution discharge balloon 9 is expanded along the surface of the expansion balloon 8 according to the expansion of the expansion balloon 8. For this reason, between the expansion balloon 8 and the drug solution discharge balloon 9, the drug solution delivered from the drug solution delivery port 13 is circulated along the surface of the expansion balloon 8 in communication with the drug solution delivery port 13 of the shaft 3. The chemical solution flow path 15 is formed.
As described above, the shaft 3 is a 3-way shaft in which the urine discharge path 10, the expansion liquid feeding path 12, and the chemical liquid feeding path 14 are formed.

  Further, the chemical solution discharge balloon 9 is formed with a chemical solution discharge port 16 that penetrates and communicates with the chemical solution flow passage 15 and the outside. The chemical solution discharge port 16 is formed so as to be located at a predetermined location in accordance with the expansion of the expansion balloon 8, and discharges the chemical solution flowing through the chemical flow passage 15 along the surface of the expansion balloon 8 to the outside. To do.

  In this way, as shown in FIG. 3, the expansion liquid injected from the expansion liquid port 6 is delivered into the expansion balloon 8 via the expansion liquid delivery port 11, whereby the expansion balloon 8 is expanded. Then, the chemical liquid injected from the chemical liquid port 7 is sent to the chemical liquid flow passage 15 via the chemical liquid delivery port 13, so that the chemical liquid discharge balloon 9 expanded together with the expansion balloon 8 reaches a predetermined position. The chemical solution is discharged from the formed chemical solution discharge port 16 to the outside.

Next, the operation of the first embodiment will be described.
First, as shown in FIG. 1, the bladder indwelling catheter is in a state in which the expansion portion 2 arranged in the vicinity of the distal end portion of the catheter body 1, that is, the expansion balloon 8 and the drug solution delivery balloon 13 are folded along the shaft 3. Then, the tip is inserted into the subject's urethra. As shown in FIG. 4A, the distal end portion of the indwelling catheter is inserted into the bladder, and the dilatation balloon 8 and the drug solution delivery balloon 13 disposed in the vicinity of the distal end portion are also located in the bladder. .

Subsequently, as shown in FIG. 2, the expansion liquid is injected from the expansion liquid port 6, and the expansion liquid sent through the expansion liquid supply path 12 enters the expansion balloon 8 from the expansion liquid outlet 11. Supplied with. By supplying the expansion fluid into the expansion balloon 8, the expansion balloon 8 expands in the bladder B together with the drug solution discharge balloon 9, as shown in FIG. It is expanded more than I. When the expansion balloon 8 is expanded to a predetermined size, the injection of the expansion liquid from the expansion liquid port 6 is stopped.
Thus, the dilatation balloon 8 is expanded to be larger than the inner urethral orifice I of the bladder B, whereby the distal end portion of the bladder indwelling catheter can be placed in the bladder B. In addition, the expansion balloon 8 expanded to be larger than the inner urethral orifice I is disposed so as to block the inner urethral orifice I, so that the urine collected in the bladder B passes through the inner urethral orifice I and enters the urethra U. Can be prevented.

When the distal end portion of the bladder indwelling catheter is placed in the bladder B, urine collected in the bladder B flows into the urine discharge hole 4 formed in the vicinity of the distal end portion of the shaft 3 and is guided to the urine discharge passage 10. Thus, urine is automatically discharged from the urine discharge port 5 to the outside of the body.
In this way, by placing a bladder indwelling catheter in the bladder, for example, when it is difficult to urinate after surgery for excision of the bladder tumor or after surgery using general anesthesia, Can be automatically discharged outside the body.

Here, as shown in FIG. 4 (B), since the bladder triangle T of the bladder B is located near the inner urethral orifice I, the bladder indwelling catheter was expanded in a state where it was placed in the bladder. The expansion balloon 8 and the drug solution discharge balloon 9 are positioned so as to cover the bladder triangle T of the bladder B. For this reason, the surface of the balloon 9 for releasing chemicals comes into contact with the bladder triangle T having many sensory nerves, and the patient feels uncomfortable.
Therefore, a chemical solution is injected from the chemical solution port 7. The injected liquid medicine is fed through the liquid medicine feed path 14 and from the liquid medicine delivery port 13 into the liquid medicine flow passage 15 formed between the surface of the expansion balloon 8 and the inner surface of the liquid medicine discharge balloon 9. Supplied. The chemical liquid supplied into the chemical liquid flow passage 15 flows along the surface of the expansion balloon 8. Then, as shown in FIG. 4C, the drug solution that has flowed through the drug solution flow passage 15 from the drug solution discharge port 16 located at a predetermined location in the bladder B according to the expansion of the dilatation balloon 8 flows into the bladder B. To be released.
For example, when the patient feels uncomfortable, the chemical solution may be intermittently administered by connecting a syringe or the like to the chemical solution port 7, or controlled at a constant pressure by connecting a syringe pump or the like to the chemical solution port 7. By doing so, it can also be administered continuously. However, since the chemical solution discharge port 16 is formed from a through-hole, and the chemical solution is discharged relatively smoothly, it is preferable to perform intermittent administration. Further, when the discharge amount of the chemical liquid discharged from the chemical liquid discharge port 16 receives the pressure of the expansion balloon 8, the discharge amount of the chemical liquid is controlled by adjusting the pressure of the expansion balloon 8 by the supply amount of the expansion liquid. It can also be controlled.

Here, when the drug solution discharge port 16 is formed so as to be positioned in the vicinity of the bladder triangle T in accordance with the expansion of the dilatation balloon 8, the drug solution released from the drug solution discharge port 16 into the bladder B is moved through the bladder triangle T. It will be administered locally to a certain area. Thereby, a chemical | medical solution is directly administered to the sensory nerve which exists in many in the bladder triangular part T, and the discomfort of the patient accompanying indwelling of a bladder indwelling catheter can be suppressed effectively. In addition, since the medicinal solution is administered aiming at the bladder triangular portion T, an extra medicinal solution is not released into the bladder B, and patient discomfort can be suppressed with a small amount of medicinal solution.
In addition, it is preferable to form the chemical | medical solution discharge port 16 of the balloon 9 for chemical | medical solution discharge | emission so that it may be located in the vicinity of the bladder triangular part T intensively, as shown in FIG.4 (B). Thereby, a chemical | medical solution can be limitedly administered only to the vicinity of the bladder triangular part T, and a patient's discomfort can be suppressed by a smaller quantity.
In this way, urine collected in the bladder B can be discharged out of the body over a long period of time while suppressing patient discomfort.

  When the treatment is completed after a predetermined period of time, the expansion liquid is extracted from the expansion liquid port 6 with a syringe or the like, and the expansion balloon 8 and the drug solution discharge balloon 9 are in the state shown in FIG. It can be folded. Then, the bladder indwelling catheter is removed from the patient's body through the urethra U.

  According to the present embodiment, by forming the drug solution discharge port 16 in the drug solution discharge balloon 9 arranged so as to cover the bladder triangle of the bladder, the drug solution is locally directed from the drug solution discharge port 16 toward the bladder triangle. Can be effectively administered, and the subject's discomfort associated with the placement of the bladder indwelling catheter can be effectively suppressed.

The number of the chemical solution discharge ports 16 formed in the chemical solution discharge balloon 9 is not particularly limited, and at least one chemical solution discharge port 16 can be formed.
Moreover, the shape of the chemical | medical solution discharge port 16 should just be able to discharge | release a chemical | medical solution outside, and is not specifically limited. For example, the chemical solution discharge port 16 can be formed from a through hole having a circular shape. Moreover, as shown in FIG. 5, the chemical | medical solution discharge port 16 can also be formed from the through-hole which has a slit shape. Furthermore, the chemical solution discharge port 16 can be configured by covering the through hole with a mesh material so that a certain resistance is generated when the drug is discharged.
In addition, in order to prevent the edge from tearing and spreading, the chemical liquid discharge port 16 may increase its strength by, for example, configuring the edge to be thick or multiplexing the chemical liquid discharge balloon 9. preferable.
In this way, by changing the number, size, edge thickness, and position of the chemical solution discharge port 16, it is possible to adjust the feeding pressure and flow rate of the chemical solution.

Embodiment 2
In the first embodiment, the drug solution discharge port 16 is formed by a through-hole penetrating the drug solution discharge balloon 9, but is not limited to this as long as the drug solution can be discharged to the outside. It can be composed of a film material having a plurality of pores of various sizes.

A porous membrane used for microfiltration, ultrafiltration, etc. can be used as the membrane material constituting the chemical solution discharge port. For example, as shown in FIG. 6, a drug solution discharge port 21 in which a continuous porous film is arranged can be formed in the drug solution discharge balloon 9 so as to make a round around the surface of the drug solution discharge balloon 9. .
When a bladder indwelling catheter having such a drug solution discharge port 21 formed in the drug solution discharge balloon 9 is placed in the bladder, the distal end portion of the bladder indwelling catheter is placed in the bladder B as in the first embodiment. The expansion liquid is supplied into the expansion balloon 8 and the drug solution discharge balloon 9 is expanded together with the expansion balloon 8. Thereby, the distal end portion of the bladder indwelling catheter is placed in the bladder B, and the urine collected in the bladder B can be discharged out of the body via the urine drainage hole 4 formed in the vicinity of the distal end portion.

At this time, it is formed between the dilatation balloon 8 and the medicinal solution discharge balloon 9 so that the subject does not feel uncomfortable because the surface of the dilated medicinal solution discharge balloon 9 contacts the bladder triangle T of the bladder B. The medicinal solution is supplied into the medicinal solution flow passage 15, and the medicinal solution flowing through the medicinal solution flow passage 15 is discharged into the bladder B through the medicinal solution discharge port 21. Here, the expanded balloon 8 for expansion and the balloon 9 for releasing chemicals are arranged so as to cover the bladder triangle T of the bladder B. Therefore, according to the expansion of the balloon 8 for expansion, for example, by releasing the drug solution from the drug solution discharge port 21 located in the vicinity of the bladder triangle T in the bladder, locally in a certain region including the bladder triangle T. A medicinal solution can be administered.
Here, the medical solution may be intermittently administered by connecting a syringe or the like to the medical solution port 7 when the patient feels uncomfortable, or connected to the medical solution port 7 by a syringe pump or the like and controlled at a constant pressure. Can also be administered continuously.
Further, since the pore diameter of the porous membrane constituting the drug solution discharge port 21 is small, it is possible to suppress the urine in the bladder B from flowing into the drug solution flow path 15 from the drug solution discharge port 21, and to maintain a constant concentration over a long period of time. Can be released into the bladder B. In addition, the urine in the bladder B can be prevented from flowing into the chemical liquid flow passage 15 from the chemical liquid discharge port 21 by setting the hole diameter of the chemical liquid discharge port 21 to 10 μm or less, and the chemical liquid by setting the hole diameter to 1 nm or more. It can suppress that the distribution | circulation at the time of discharge | release is carried out.

In this way, urine collected in the bladder B can be discharged out of the body for a long period of time while suppressing patient discomfort associated with the placement of the bladder indwelling catheter.
According to the present embodiment, in order to suppress the urine in the bladder B from flowing into the drug solution flow passage 15 from the drug solution discharge port 21, the drug solution having a constant concentration for a long period of time including the bladder triangle T is provided. It can be administered to the region, and the subject's discomfort associated with the placement of the bladder indwelling catheter can be more effectively suppressed.

A dialysis membrane can also be used as the membrane material constituting the chemical solution discharge port. When a dialysis membrane is used, the outflow of the chemical component is not controlled by pressure, but is controlled by osmotic pressure difference.
Furthermore, as shown in FIG. 7, the chemical solution discharge port 22 is formed in the chemical solution discharge balloon 9 by arranging a plurality of film materials so as to make one round of the circumference along the surface of the chemical solution discharge balloon 9. You can also.
In this way, the amount of chemical solution released and the liquid delivery pressure can be controlled by changing the membrane material, membrane pore diameter, number, area, thickness, position, and the like constituting the chemical solution outlet.

In addition, the chemical solution outlet should use materials used for microfiltration membranes such as polycarbonate, polyvinylidene fluoride, polytetrafluoroethylene, polypropylene, polyamide, cellulose ester, polysulfone, polyetherimide, and polyetheretherketone. Can do. Materials used for ultrafiltration membranes such as polysulfone / polyethersulfone, polyacrylonitrile, cellulose ester, polyimide / polyetherimide, aliphatic polyamide, polyvinylidene fluoride, polyetheretherketone, etc. Can also be used.
A dialysis membrane material such as cellophane, caprohan, cellulose acetate, ethylene-vinyl alcohol copolymer, ethylene-vinyl acetate copolymer can also be used for the chemical solution discharge port.

Embodiment 3
In the first and second embodiments, the drug solution balloon is configured to surround the entire circumference of the dilatation balloon so as to form a double balloon with the dilatation balloon. It should just be comprised along the surface, and is not restricted to this.

For example, as shown in FIG. 8, the drug solution discharge balloon 32 can be formed so as to cover only the rear half of the expansion balloon 31 arranged in the vicinity of the tip of the shaft 3.
As shown in FIG. 9, by supplying the expansion liquid into the expansion balloon 31 via the expansion liquid supply path 12, the expansion balloon 31 is expanded together with the drug solution discharge balloon 32. At this time, a chemical flow path 33 is formed along the surface of the expansion balloon 31 between the rear side surface of the expansion balloon 31 and the inner surface of the chemical discharge balloon 32. The chemical liquid is supplied to the liquid via the chemical liquid supply path 14. The medicinal solution supplied into the medicinal solution flow passage 33 flows along the surface of the rear side of the dilatation balloon 31 and is discharged into the bladder B from the medicinal solution discharge port 16 formed in the medicinal solution discharge balloon 32.

  According to the present embodiment, the flow volume of the chemical liquid can be reduced by disposing the expansion balloon 32 only on the rear side of the expansion balloon 31 and reducing the range in which the chemical flow path 33 is formed. The amount of the chemical liquid discharged from the chemical liquid discharge port 16 can be accurately controlled.

  Note that the chemical flow passage only needs to communicate between the chemical solution delivery port 13 and the chemical solution discharge port 16. For example, as shown in FIG. 10, the chemical solution that communicates the chemical solution delivery port 13 and the chemical solution discharge port 16 at the shortest distance. A flow passage 34 can be formed. That is, the drug solution discharge port 16 is formed at a predetermined position of the drug solution discharge balloon 35, for example, a position located near the bladder triangular portion T when the dilatation balloon 31 is expanded in the bladder B, and the drug solution discharge port 16. The medical solution discharge balloon 35 is disposed along the surface of the dilatation balloon 31 so as to cover only between the medical solution delivery port 13 and the medical solution delivery port 13. In this way, by forming the chemical liquid flow passage 34 that connects the chemical liquid delivery port 13 and the chemical liquid discharge port 16 at the shortest distance, the discharge amount of the chemical liquid discharged from the chemical liquid discharge port 16 can be controlled more accurately. .

In the above embodiment, the chemical flow passage is formed between the expansion balloon and the chemical discharge balloon. However, the chemical flow path only needs to be formed along the surface of the expansion balloon. is not.
For example, as shown in FIG. 11, instead of the drug solution discharge balloon 9, a drug solution discharge tube 37 having a side part bonded to the surface of the expansion balloon 36 is arranged, and one end of the tube is a drug solution delivery port 13 of the shaft 3. And a chemical solution discharge port 38 is formed at the other end. In addition, a chemical solution flow passage that connects the chemical solution delivery port 13 and the chemical solution discharge port 38 is formed inside the chemical solution discharge tube 37.
When the dilatation balloon 36 is expanded in the bladder, the medicinal solution discharge tube 37 adhered to the surface of the dilatation balloon 36 also moves in accordance with the expansion of the dilatation balloon 36, and the medicinal solution discharge port 38 is moved to the vicinity of the bladder triangle T. . In this state, by injecting the chemical solution from the chemical solution port 7, the chemical solution sent from the chemical solution outlet 13 into the chemical solution flow passage flows to the chemical solution discharge port 38 along the chemical solution flow passage, and the chemical solution discharge port 38. Is released into the bladder. As described above, since the position of the drug solution discharge port 38 is arranged in the vicinity of the bladder triangle T as the dilatation balloon 36 is expanded, the drug solution is locally administered from the drug solution discharge port 38 toward the bladder triangle T. be able to.

The chemical solution discharge tube 37 can be made of a material such as polyolefin, polyvinyl chloride, polyacetal, polyester, polyamide resin, polyurethane, polystyrene, or polycarbonate.
In addition, the chemical solution discharge port 38 can be formed of a through-hole or a membrane material, but urine collected in the bladder does not flow into the chemical solution flow path through the chemical solution discharge port 38, for example, as shown in FIG. It is also possible to provide a check valve 39 that can be deformed only in the external direction, as shown in (A) and (B). That is, the check valve 39 is closed when no chemical is sent from the chemical flow passage toward the chemical discharge port 38, whereas when the chemical is sent from the chemical flow passage toward the chemical discharge port 38, the check valve 39 is closed. The check valve 39 is deformed outward by the pressure. When the check valve 39 is deformed, the chemical solution discharge port 38 is opened, and the chemical solution is discharged from the chemical solution discharge port 38 to the outside. As described above, the check valve 39 is configured to be opened toward the outside only when the drug solution is released and not to be opened inward, so that the urine in the bladder B flows into the drug solution passage. Can be suppressed. As a material for the check valve 39, silicone, fluororesin, nylon, polyolefin, polyvinyl chloride, polycarbonate, or the like can be used.

Embodiment 4
In the above first to third embodiments, the drug solution is released only from the drug solution outlet into the bladder, but the drug solution can also be released to both the bladder and the urethra.
For example, as shown in FIG. 13, in the bladder indwelling catheter of the first embodiment, at least one intraurethral drug solution discharge port 41 that communicates with the drug solution delivery path 14 and the outside can be formed in the middle portion of the shaft 3. . As a result, the medicinal solution delivered through the medicinal solution delivery path 14 is released into the bladder B from the medicinal solution discharge port 16 formed in the medicinal solution discharge balloon 9 and in the urethra formed in the middle portion of the shaft 3. It is discharged into the urethra U from the chemical solution discharge port 41. Thus, by administering a chemical | medical solution to both the urinary bladder B and the urethra U, the test subject's discomfort accompanying indwelling of a bladder indwelling catheter can be suppressed more effectively.
In addition, as shown in FIG. 14, at least one intraurethral liquid supply path is provided inside the shaft 3 separately from the liquid supply path 14 for supplying the liquid for discharge into the bladder B from the liquid discharge port 16. 42 can be formed, and the intraurethral drug solution delivery path 43 can be formed in the middle portion of the shaft 3 to communicate with the outside of the urethral drug solution feed path 42. As a result, the medicinal solution delivered through the medicinal solution delivery path 14 is released into the bladder B from the medicinal solution discharge port 16 formed in the medicinal solution discharge balloon 9 while being fed through the intraurethral medicinal solution delivery path 42. The drug solution is discharged into the urethra U from the urethral drug solution discharge port 43 formed in the middle portion of the shaft 3. In this way, the amount of the drug solution released into the bladder B and the urethra U by sending the drug solution from the drug solution delivery path 14 and the intraurethral drug solution delivery path 42 to the drug solution outlet 16 and the intraurethral drug outlet 43, respectively. Can be accurately adjusted, and an appropriate amount of drug solution can be administered to each site. In addition, the shaft 3 can increase a liquid feeding path according to the use purpose of a bladder indwelling catheter as mentioned above, In this invention, a 3 Way or more thing can be used.

  DESCRIPTION OF SYMBOLS 1 Catheter main body, 2 expansion part, 3 shaft, 4 urine discharge hole, 5 urine discharge port, 6 expansion liquid port, 7 drug solution port, 8,31 expansion balloon, 9, 32, 35, 36 Balloon, 10 Urine discharge path, 11 Expansion liquid delivery outlet, 12 Expansion liquid delivery path, 13 Chemical liquid delivery outlet, 14 Chemical liquid delivery path, 15, 33, 34 Chemical liquid flow path, 16, 21, 22, 38 Chemical liquid discharge outlet 37, drug solution release tube, 39 check valve, 41, 43 urethral drug solution outlet, 42 urethral drug solution channel, B bladder, T bladder triangle, I internal urethra, U urethra.

Claims (12)

A bladder indwelling catheter in which a balloon for dilatation to be expanded in the bladder is disposed in the vicinity of the distal end portion of the catheter body,
The catheter body has a drug solution feeding path for feeding a drug solution to the vicinity of the distal end portion extending from the vicinity of the distal end portion to the proximal end portion,
A medical fluid flow path that communicates with the chemical fluid delivery path in the vicinity of the distal end portion of the catheter body and distributes the chemical fluid along the surface of the expanded balloon, and a predetermined location according to the expansion of the expansion balloon A bladder indwelling catheter, comprising: a medicinal solution discharge portion that is disposed in the at least one medicinal solution discharge port through which the medicinal solution flowing through the medicinal solution flow passage is discharged into the bladder. The dilatation balloon is dilated to cover the bladder triangle of the bladder;
The bladder indwelling catheter according to claim 1, wherein the drug solution discharge port is formed so as to be disposed in the vicinity of a bladder triangular portion according to expansion of the balloon for expansion.   The bladder indwelling catheter according to claim 1 or 2, wherein the drug solution discharge port is formed from a through hole having a circular shape or a slit shape.   The bladder indwelling catheter according to claim 1 or 2, wherein the drug solution discharge port is configured by covering a through hole with a mesh material.   The bladder indwelling catheter according to claim 1 or 2, wherein the drug solution discharge port is made of a membrane material having a plurality of holes having a size of 1 nm to 10 µm.   The bladder indwelling catheter according to claim 5, wherein the membrane material is composed of a porous membrane or a dialysis membrane.   The bladder indwelling catheter according to claim 4 or 5, wherein the medicinal solution discharge port is formed by arranging the continuous membrane material or a plurality of the membrane materials so as to surround the dilatation balloon. The medicinal solution discharge portion is composed of a medicinal solution discharge balloon that surrounds the entire circumference of the dilatation balloon so as to form a double balloon with the dilatation balloon,
The bladder indwelling catheter according to any one of claims 1 to 7, wherein the drug solution flow passage is formed between a surface of the dilatation balloon and an inner surface of the drug solution discharge balloon.   The bladder indwelling catheter according to any one of claims 1 to 7, wherein the drug solution discharge portion is configured along a part of the surface of the dilatation balloon.   The drug solution discharge part is composed of a tube whose side part is bonded to the surface of the balloon for expansion, one end of which communicates with the drug solution delivery path of the catheter body, and the drug solution discharge port is formed at the other end. The bladder indwelling catheter according to claim 9.   The indwelling bladder catheter according to any one of Claims 1 to 10, wherein the catheter body has at least one intraurethral drug solution outlet for discharging the drug solution fed through the drug solution feeding path into the urethra. .   The catheter body further includes a urethral drug solution supply path for supplying a drug solution extending from the base end portion to the middle portion, and the drug solution is communicated with the outside in the urethra. The indwelling urinary catheter according to any one of claims 1 to 10, wherein at least one intraurethral drug solution outlet for release into the urinary tract is formed.

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