Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/18—Applying electric currents by contact electrodes
  • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
  • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
  • A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control

Definitions

• This invention relates generally to selective nerve stimulation for bladder
• urinary calculi remains a major factor leading to morbidity in spinal cord injured
• urethral or anal sphincter allows the development of techniques to selectively
• the motor impulse is
• sacral nerves are separated to isolate the ventral and dorsal roots thereof, and the
• inferior somatic nerve SI is sectioned to isolate the external sphincter on one side.
• the dorsal root of S2 is then sectioned unilaterally to isolate the sensory function
• An electrode is positioned on the S3 sacral nerve to stimulate the detrusor
• sphincter response may be
• the present invention contemplates a new technique for bladder function
• sacral motor roots and also the sacral sensory roots.
• FIG. 1 schematically illustrates the placement of electrodes for controlling the
• FIG. 2 is a graphic representation showing average voided volume from
• FIG. 3 is a graphic representation showing average voided volume when
• FIG. 4 illustrates a stimulation scheme which may be used for combined
• FIG. 1 there is shown an illustrative embodiment of the
• Kidney 10 is
• Urine is expelled from the body through bladder neck 16 and
• urethra 18 and out from urethral sphincter 20.
• Bladder 12 and sphincter 20 function
• Dorsal roots 23 are primarily sensory (afferent) to transmit sensation to spinal cord 19, while ventral roots 22
• Ventral roots 22 include nerve bundles 22a which include larger diameter
• nerve fibers and nerve bundles 22b which include smaller diameter fibers. Larger
• fibers 22a connect between spinal cord 19 and sphincter 20, while smaller fibers 22b
• Smaller fibers 22b usually carry no action potentials until the person desires
• a cuff electrode 30 can be
• Cuff electrode 30 which is preferably a self-curling spiral electrode that is biased to curl around the selected root and is described in U.S. Patent No. 4,602,624, is configured to accommodate nerves of
• the present invention also includes an additional cuff electrode 32 which is
• roots can result in the voiding of bladder contents without increasing sphincter
• a controller 34 is electrically coupled to electrodes 30 and 32 to provide
• nerve cuff electrode implanted on S2 motor roots. Either a quasitrapezoidal, balanced biphasic, 20 Hz pulse, with current amplitude set at a volume determined
• the efferent sensory stimulus was applied to the S2 dermatome
• the surface stimulus was varied to be continuous or intermittent (1 second
• FIG. 2 shows the average volume of fluid voided during a 10 second pulse
• halothane inhalation anesthesia The motor stimulus was applied by a spiral nerve
• the sensory stimulus was applied to SI, S2, or
• the intermittent surface stimulation was varied to be either 1
• Table 1 shows the average results from three trials for each stimulus pattern.
• FIG. 3 shows the
• V(ml) Average voided volume in ml
• FIG. 4 illustrates the stimulus pattern for the combined dorsal and ventral
• An intermittent pulse train 100 is applied
• pressure bladder activation can be achieved by modulating the reflexes associated
• Pulse train 100 preferably consists of pulses delivered at a frequency of 10 to
• each pulse having a nominal amplitude of less than 1 ma and a pulse
• Pulse train 100 is generated intermittently, with a
• Pulse train 102 preferably

Landscapes

• Health & Medical Sciences (AREA)
• Gastroenterology & Hepatology (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Radiology & Medical Imaging (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Electrotherapy Devices (AREA)

Applications Claiming Priority (3)

Publications (1)

Family

ID=22280289

Family Applications (1)

Country Status (4)

Families Citing this family (14)

Family Cites Families (8)

• 1999
  • 1999-09-14 WO PCT/US1999/021049 patent/WO2000015293A1/en not_active Application Discontinuation
  • 1999-09-14 EP EP99951446A patent/EP1113841A1/de not_active Withdrawn
  • 1999-09-14 AU AU63885/99A patent/AU758611B2/en not_active Ceased
  • 1999-09-14 CA CA002343928A patent/CA2343928A1/en not_active Abandoned

Non-Patent Citations (1)

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