US3236240A - Implantable bladder stimulator - Google Patents
Implantable bladder stimulator Download PDFInfo
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- US3236240A US3236240A US221754A US22175462A US3236240A US 3236240 A US3236240 A US 3236240A US 221754 A US221754 A US 221754A US 22175462 A US22175462 A US 22175462A US 3236240 A US3236240 A US 3236240A
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- bladder
- stimulator
- receiver
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- 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
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S128/00—Surgery
- Y10S128/903—Radio telemetry
Definitions
- This invention relates to a method and means for artificially electrically stimulating the bladder of persons who have lost the ability to voluntarily empty the bladder because of spinal cord or other injury or disease.
- a catheter Prior to the present invention, the use of a catheter has been the only means of emptying the bladder of paraplegics and others similarly affected.
- Urinary sepsis secondary to neurogenic dysfunction associated with spinal cord trauma, is a well recognized clinical problem. Prolonged use of indwelling catheters in paraplegic patients produces significant bacteriuria, cystitis, vesical calculi, and pyelonephritis. It has been shown that use of an indwelling catheter for 24 hours results in bacteriuria in 50% of patients and in 98-l00% of patients after four days.
- Bladder tonus or the response of bladder smooth muscle to the stretch imposed by filling, has been described as an intrinsic property of smooth muscle and not reflex in nature. Changes in this response are shown to follow physical alteration in the bladder tissue. Regular, complete evacuation of the neurogenic bladder with avoidance of infection and damage, is therefore an aid in preserving normal tonus and facilitating rehabilitation of bladder function. Electrical excitability of the mammalian bladder has been demonstrated.
- a still further object of this invention is to provide a battery powered implantable bladder stimulator adapted to be actuated through a pressure switch by external pressure applied to the skin over the switch.
- this invention then comprises the eatures herein- 3,236,243 Patented Feb. 22, 1966 ice after fully described and particularly pointed out in the claims, the following description setting forth in detail certain illustrative embodiments of the invention, these being indicative, however, of but a few of the various Ways in which the principles of the invention may be employed.
- FIGURE l is a perspective view of an internal stimulator according to the present invention.
- FIGURE 2 is a schematic block circuit diagram of an implantable bladder stimulator deriving its stimulation power from an external high power transmitter;
- FIGURE 3 is a schematic block circuit diagram of an implantable bladder stimulator' deriving its stimulation power from an internal battery power pack and adapted to be triggered from an external radio frequency transmitter;
- FIGURE 4 is a schematic black circuit diagram of an implantable bladder stimulator deriving its stimulation power from an internal power pack and adapted to be actuated by pressure.
- the stimulator comprises a receiver, indicated generally at 1t), and a plurality of electrodes 11 for attachment to the bladder.
- the electrodes 1i are connected to the receiver by electrical conductors 12.
- the receiver is encased in a protective plastic mass 13 preferably composed of a synthetic resinous material.
- the conductors are similarly encased in a protective sheath 14.
- the bladder stimulator receiver unit includes a tuned tank circuit composed of an inductor and a capacitor in a parallel connected resonant circuit. Since such a circuit has the ability to store energy for a short period of time, its acts as a reservoir or tank.
- the inductor of the tank circuit acts as an antenna. Pulses of radio frequency energy from an external high power transmitter of conventional design are transmitted through a layer of body tissue to the receiver where they are rectified through a rectifier, into a unidirectional pulsating current.
- the radio frequency current is filtered out and the lower frequency pulse envelope signal is applied to the bladder through bladder electrodes 11 attached to the bladder wall, through an output coupling capacitor which blocks the direct current component of the signal.
- the bladder electrodes l1 are metallic terminals attached directly to the exterior wall of the bladder.
- the receiver components are encased or embedded in a sterilizable, inert, non-irritating and non-toxic protective and insulating mass 12, preferably of synthetic resinous material, with only the conductors 12 leading to the bladder electrodes 11 extending therefrom.
- a sterilizable, inert, non-irritating and non-toxic protective and insulating mass 12 preferably of synthetic resinous material, with only the conductors 12 leading to the bladder electrodes 11 extending therefrom.
- These c-onductors are insulated by passing them through tubes 14, preferably of similar synthetic resinous protective and insulating material, or coated with a similar substance.
- Substances such as silicone rubber, silastic resins, tetrauoroethylene polymers, vinyl chloride and the like, are suitable materials for these purposes. Pure natural rubber may also be used.
- the bladder electrodes may be formed from any inert non-toxic and non-irritating electrically conductive metal. Surgicail grade stainless steel is a preferred material. However, other metals such as tantalum, gold, silver, platinum and alloys of these metals may also be used. According to one form the electrodes are circular discs of the order of about 0.5 to 1.5 centimeters in diameter and protected on one side with an insulating material. The electrodes may be solid or perforated or formed from metallic mesh. The electrodes are attached with silk sutures or the like sewn through the outermost layer of the bladder wall with the exposed surface in direct contact with the wall. Two to four leads or more may be connected from the receiver to the bladder depending upon the size of the bladder.
- the reiver-stimulator is implanted under the skin of the patient with the electrodes attached directly to the bladder wall.
- the transmitter which accompanies the receiver generates pulses of radio frequency energy of the sa-me frequency of the tuned tank circuit modulated to the proper shape and pulse recurrence frequency to give the correct bladder stimulation. This is of the order of about one-half to two megacycles, and desirably about one megacycle.
- the transmitted radio frequency energy is applied to the patient by means of a small loop antenna at the end of a cable extending from the radio frequency generator. This loop is held next to the skin directly over the implanted receiver.
- the transmitted signal stimulates the bladder through the bladder electrodes and causes the badder to empty.
- the components of the stimulator are desirably selected to apply a biphasic signal of amplitude of aboue 1 to 50 volts depending upon the size of the electrodes, the voltage varying inversely with the contact area of the electrodes.
- the pulse recurrence frequency may be up to about 20 times the pulse duration and may be, for example, of the order of about 20 to 2000 cycles per second. In one typical instance 6 electrodes of l centimeter diameter were attached to a bladder and the applied signal was of the order of about volt, 2 millisecond pulses at the rate o-f about 50 to 100 per second.
- FIGURE 3 there is shown a self-powered receiver-stimulator, indicated generally at 10A, which contains its own battery power supply.
- This receiverstimulator includes a tuned tank :circuit whose inductor Vsimilarly acts as an antenna.
- the pulses of radio frequency energy from a llow power transmitter are transmitted to a radio frequency operated switch which controls the battery po-wer pack to energize a multivibrator.
- the output of the multivibrator is applied to the bladder through an output coupling capacitor to block the ow of direct current while permitting pulsating current to pass.
- the stimulation is applied through the bladder electrodes 11 attached directly to the bladder wall.
- This type of receiver-stimulator is likewise encased in a resinous protective and insulating material 13 and implanted directly in the body of the patient under the skin. It has the advantage of permitting the use o-f a smaller more portable transmitter of pulses of radio frequency energy. Along with this is the disadvantage of a limited life, dependent upon the life of the battery power pack. However, the greater mobility of the patient permitted by the self-powered unit will in most cases outweigh this disadvantage.
- the implanted stimulator may be used over an extended period of time with minimal tissue reaction in the region of the electrodes and only slight thickening of the subcutaneous tissues around the site of implantation of the receiver. Meanwhile, infection and subsequent bladder tissue changes resulting from the use of urethral catheters is avoided and bladder tonus is maintained, preserving an intact organ and sphincters.
- ultrasonic vibrations may be used in a similar manner.
- FIGURE 4 there is shown a modified form of stimulator, indicated generally at 10B, which also contains its own battery power supply.
- the circuit of this stimulator includes a pressure operated switch which may be actuated by finger pressure exerted on the overlying skin.
- the pressure switch controls the battery power pack to energize a multivibrator.
- the output of the multivibrator is applied to the bladder through an output coupling capacitor and the stimulation is applied to the bladder as previously described.
- This unit is insulated and embedded in protective material in the same manner as the other forms of stimulator and is implanted so that the pressure switch may be easily actuated by finger pressure on the skin overlying the unit.
- a volitional stimulator for the stimulation of a distended bladder to cause the emptying thereof intermittently at widely spaced time intervals dictated by liquid intake into the bladder said stimulator including (A) means for producing controllable intermittent electrical stimuli having an amplitude of about 1 to 50 volts and a pulse recurrence frequency of the order of about 20 to 2000 cycles per second, said frequency being up to about 20 times the pulse duration,
- said means for producing electrical stimuli and said conductor means being encased in an inert nontoxic and non-irritant protective material in a relatively flat wafer-like envelope and elongated flexible sheaths, respectively, for implantation within the body.
- a stimulator according to claim 1 further characterized in that said means for producing electrical stimuli is a radio frequency receiver.
- said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively at wafer-like envelope and elongated sheaths, respectively, for implantation Within the body.
- a receiver-stimulator according to claim 3 further characterized in that said receiver includes a radio frequency tuned tank circuit, the inductor of said tank circuit being an antenna for an external radio frequency signal.
- a receiver-stimulator according to claim 3 further characterized in that said receiver includes an output coupling capacitor to block the flow of direct current to said electrodes.
- a receiver-stimulator further characterized in that said receiver includes means for adapting said receiver to be powered by an external high power radio frequency generator and includes a rectifier for imparting unidirectional ow to the electrical stimulus to said electrodes and a filter to block the ow of radio frequency current.
- (E) means for applying said pulsing electrical stimulus for short time intervals suicient to substantially empty said bladder at Widely spaced time intervals dictated by liquid intake into said bladder,
- said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively at wafer-like envelope and elongated eXible sheaths, respectively, for implanting Within the body.
- (D) means within said receiver for altering an externally transmitted radio frequency signal and applying a pulsing electrical stimulus to the bladder wall through said electrode means including:
- (E) means for applying said pulsing electrical stimulus for short time intervals sufficient to substantially empty said bladder at widely spaced time intervals dictated by liquid intake to said bladder,
- said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively llat Wafer-like envelope and elongated flexible sheaths, respectively, for implanting Within the body.
- a volitional method for artificially causing a distended bladder to be emptied intermittently at widely spaced time intervals dictated by liquid intake into said bladder comprises the steps of (A) mplanting a means for producing electrical stimuli within the body,
- said stimuli having an amplitude of about 1 to 50 volts and a pulse recurrence frequency of the order of about 20 to 2000 cycles per second, said frequency being up to about 20 times the pulse duration.
Description
Feb. 22, 1966 Filed Sept. 6, 1962 W. E. BRADLEY IMPLANTABLE BLADDER STIMULATOR 2 Sheets-51u29.tl 1
2 Sheets-Sheet 2 Filed Sept. 6, 1962 @Mone/e I fzcmoogs (APAf/TR 0U TPU T COI/PLING l BATTERY POWER PACK PRESS UR E UPERATED `SWITCH INVENTOR. M//LL mM E BRADLEY ATTORNEYJ United States Patent O1 3,236,240 IMPLANTABLE BLADDER STIMULATOR William E. Bradley, Minneapolis, Minn., assignor to The Regents of The University of Minnesota, Minneapolis, Minn., a corporation of Minnesota Fiied Sept. 6, 1962, Ser. No. 221,754 9 Claims. (Cl. 12S-421) This invention relates to a method and means for artificially electrically stimulating the bladder of persons who have lost the ability to voluntarily empty the bladder because of spinal cord or other injury or disease. Prior to the present invention, the use of a catheter has been the only means of emptying the bladder of paraplegics and others similarly affected.
Urinary sepsis, secondary to neurogenic dysfunction associated with spinal cord trauma, is a well recognized clinical problem. Prolonged use of indwelling catheters in paraplegic patients produces significant bacteriuria, cystitis, vesical calculi, and pyelonephritis. It has been shown that use of an indwelling catheter for 24 hours results in bacteriuria in 50% of patients and in 98-l00% of patients after four days.
With antibiotic therapy and closer attention to bladder rehabilitation during and after World War II, the mortality rate in paraplegics from urinary sepsis has declined. However, of approximately 746 veterans with spinal cord injury who died during the period of nine years following World War Il, death was attributed to urinary tract infection in 64%. In another series of patients, urinary tract damage was found in 65% of those dying from other causes.
Bladder tonus, or the response of bladder smooth muscle to the stretch imposed by filling, has been described as an intrinsic property of smooth muscle and not reflex in nature. Changes in this response are shown to follow physical alteration in the bladder tissue. Regular, complete evacuation of the neurogenic bladder with avoidance of infection and damage, is therefore an aid in preserving normal tonus and facilitating rehabilitation of bladder function. Electrical excitability of the mammalian bladder has been demonstrated.
It is accordingly the principal object of this invention to provide a practical method and means for artificially electrically stimulating the bladder to permit regular, complete evacuation with the avoidance of infection and tissue damage.
It is a further object of this invention to provide an implantable internal bladder stimulator in the form of a radio frequency receiver with electrodes attached to the bladder, capable of providing the proper stimulation when used in conjunction with an external radio frequency transmitter.
It is another object of this invention to provide a passive internal bladder stimulator adapted to be implanted subcutaneously with electrodes attached to the bladder which derives its stimulation power from an external high power radio frequency transmitter.
It is another object of the present invention to provide a battery powered implantable bladder stimulator adapted to be triggered by a low power signal from an external pocket size radio frequency transmitter.
A still further object of this invention is to provide a battery powered implantable bladder stimulator adapted to be actuated through a pressure switch by external pressure applied to the skin over the switch.
Other and further objects of the invention are those inherent and apparent in the apparatus as described, pictured and claimed.
To the accomplishment of the foregoing and related ends, this invention then comprises the eatures herein- 3,236,243 Patented Feb. 22, 1966 ice after fully described and particularly pointed out in the claims, the following description setting forth in detail certain illustrative embodiments of the invention, these being indicative, however, of but a few of the various Ways in which the principles of the invention may be employed.
The invention will be described with reference to the drawings in which corresponding numerals refer to the same parts and in which:
FIGURE l is a perspective view of an internal stimulator according to the present invention;
FIGURE 2 is a schematic block circuit diagram of an implantable bladder stimulator deriving its stimulation power from an external high power transmitter;
FIGURE 3 is a schematic block circuit diagram of an implantable bladder stimulator' deriving its stimulation power from an internal battery power pack and adapted to be triggered from an external radio frequency transmitter; and
FIGURE 4 is a schematic black circuit diagram of an implantable bladder stimulator deriving its stimulation power from an internal power pack and adapted to be actuated by pressure.
As shown in FIGURE l, the stimulator comprises a receiver, indicated generally at 1t), and a plurality of electrodes 11 for attachment to the bladder. The electrodes 1i are connected to the receiver by electrical conductors 12. The receiver is encased in a protective plastic mass 13 preferably composed of a synthetic resinous material. The conductors are similarly encased in a protective sheath 14.
Referring to FIGURE 2 of the drawings, the bladder stimulator receiver unit includes a tuned tank circuit composed of an inductor and a capacitor in a parallel connected resonant circuit. Since such a circuit has the ability to store energy for a short period of time, its acts as a reservoir or tank. The inductor of the tank circuit acts as an antenna. Pulses of radio frequency energy from an external high power transmitter of conventional design are transmitted through a layer of body tissue to the receiver where they are rectified through a rectifier, into a unidirectional pulsating current. The radio frequency current is filtered out and the lower frequency pulse envelope signal is applied to the bladder through bladder electrodes 11 attached to the bladder wall, through an output coupling capacitor which blocks the direct current component of the signal. The bladder electrodes l1 are metallic terminals attached directly to the exterior wall of the bladder.
The receiver components are encased or embedded in a sterilizable, inert, non-irritating and non-toxic protective and insulating mass 12, preferably of synthetic resinous material, with only the conductors 12 leading to the bladder electrodes 11 extending therefrom. These c-onductors are insulated by passing them through tubes 14, preferably of similar synthetic resinous protective and insulating material, or coated with a similar substance. Substances such as silicone rubber, silastic resins, tetrauoroethylene polymers, vinyl chloride and the like, are suitable materials for these purposes. Pure natural rubber may also be used.
The bladder electrodes may be formed from any inert non-toxic and non-irritating electrically conductive metal. Surgicail grade stainless steel is a preferred material. However, other metals such as tantalum, gold, silver, platinum and alloys of these metals may also be used. According to one form the electrodes are circular discs of the order of about 0.5 to 1.5 centimeters in diameter and protected on one side with an insulating material. The electrodes may be solid or perforated or formed from metallic mesh. The electrodes are attached with silk sutures or the like sewn through the outermost layer of the bladder wall with the exposed surface in direct contact with the wall. Two to four leads or more may be connected from the receiver to the bladder depending upon the size of the bladder.
The reiver-stimulator is implanted under the skin of the patient with the electrodes attached directly to the bladder wall. The transmitter which accompanies the receiver generates pulses of radio frequency energy of the sa-me frequency of the tuned tank circuit modulated to the proper shape and pulse recurrence frequency to give the correct bladder stimulation. This is of the order of about one-half to two megacycles, and desirably about one megacycle. The transmitted radio frequency energy is applied to the patient by means of a small loop antenna at the end of a cable extending from the radio frequency generator. This loop is held next to the skin directly over the implanted receiver. The transmitted signal stimulates the bladder through the bladder electrodes and causes the badder to empty.
Although the bladder has been found to be responsive to wide variations in applied signal the components of the stimulator are desirably selected to apply a biphasic signal of amplitude of aboue 1 to 50 volts depending upon the size of the electrodes, the voltage varying inversely with the contact area of the electrodes. The pulse recurrence frequency may be up to about 20 times the pulse duration and may be, for example, of the order of about 20 to 2000 cycles per second. In one typical instance 6 electrodes of l centimeter diameter were attached to a bladder and the applied signal was of the order of about volt, 2 millisecond pulses at the rate o-f about 50 to 100 per second.
Referring to FIGURE 3 there is shown a self-powered receiver-stimulator, indicated generally at 10A, which contains its own battery power supply. This receiverstimulator includes a tuned tank :circuit whose inductor Vsimilarly acts as an antenna. The pulses of radio frequency energy from a llow power transmitter are transmitted to a radio frequency operated switch which controls the battery po-wer pack to energize a multivibrator. The output of the multivibrator is applied to the bladder through an output coupling capacitor to block the ow of direct current while permitting pulsating current to pass. The stimulation is applied through the bladder electrodes 11 attached directly to the bladder wall.
This type of receiver-stimulator is likewise encased in a resinous protective and insulating material 13 and implanted directly in the body of the patient under the skin. It has the advantage of permitting the use o-f a smaller more portable transmitter of pulses of radio frequency energy. Along with this is the disadvantage of a limited life, dependent upon the life of the battery power pack. However, the greater mobility of the patient permitted by the self-powered unit will in most cases outweigh this disadvantage.
It has been found that eifective and complete emptying of the bladder with no residual urine may be accomplished through use o-f the receiver-stimulator according to the present invention. Emptying is time-cycled and the bladder is emptied rat regular intervals. For example, a timer may be used to trigger the transmitter every four hours for a period of three minutes. lt will be understood, of course, that the length and frequency of stimulation may vary ywidely dependent upon the fluid intake, the condition of the patient, and other variables.
The implanted stimulator may be used over an extended period of time with minimal tissue reaction in the region of the electrodes and only slight thickening of the subcutaneous tissues around the site of implantation of the receiver. Meanwhile, infection and subsequent bladder tissue changes resulting from the use of urethral catheters is avoided and bladder tonus is maintained, preserving an intact organ and sphincters. Instead of utilizing radio d, frequency signals as described, ultrasonic vibrations may be used in a similar manner.
In FIGURE 4 there is shown a modified form of stimulator, indicated generally at 10B, which also contains its own battery power supply. The circuit of this stimulator includes a pressure operated switch which may be actuated by finger pressure exerted on the overlying skin. The pressure switch controls the battery power pack to energize a multivibrator. The output of the multivibrator is applied to the bladder through an output coupling capacitor and the stimulation is applied to the bladder as previously described. By means of this form of stimulator the patient has greater freedom and direct control over evacuation of his bladder. This unit is insulated and embedded in protective material in the same manner as the other forms of stimulator and is implanted so that the pressure switch may be easily actuated by finger pressure on the skin overlying the unit.
lt is apparent that many modifications and variations of this invention as hereinbefore set forth may be made without departing from the spirit and scope thereof. The specific embodiments described are given by way of example only and the invention is limited only by the terms of the appended claims.
I claim:
1. A volitional stimulator for the stimulation of a distended bladder to cause the emptying thereof intermittently at widely spaced time intervals dictated by liquid intake into the bladder, said stimulator including (A) means for producing controllable intermittent electrical stimuli having an amplitude of about 1 to 50 volts and a pulse recurrence frequency of the order of about 20 to 2000 cycles per second, said frequency being up to about 20 times the pulse duration,
(B) at least two separate electrode means for direct attachment to the bladder wall at variable relatively widely spaced distances,
(C) iiexible electrical conductor means connecting said electrode means to said means for producing electrical stimuli,
(D) means for actuating said means for producing electrical stimuli to turn said means on to apply a pulsing electrical stimulus to the bladder wall through said electrode means,
(E) means for manually controlling said actuating means for applying said stimulus for a short time interval sufficient to substantially empty said bladder intermittently at said widely spaced time intervals dictated by liquid intake into the bladder,
(F) said means for producing electrical stimuli and said conductor means being encased in an inert nontoxic and non-irritant protective material in a relatively flat wafer-like envelope and elongated flexible sheaths, respectively, for implantation within the body.
2. A stimulator according to claim 1 further characterized in that said means for producing electrical stimuli is a radio frequency receiver.
3. A volitional receiver-stimulator for the stimulation of a distended bladder to cause emptying thereof intermittently at widely spaced time intervals dictated by liquid intake into the bladder, said stimulator including (A) a radio frequency receiver,
(B) at least two separate electrode means for direct attachment to the bladder wall at variable relatively widely spaced distances,
(C) exible electrical conductor means connecting said receiver and electrode means,
(D) means within the receiver for applying a pulsing electrical stimulus to the bladder through said electrode means,
(E) means for actuating said stimulus applying means to turn said means on for short time intervals sufcient to substantially empty said bladder at said intermittent widely spaced time intervals dictated by liquid intake into said bladder,
(F) said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively at wafer-like envelope and elongated sheaths, respectively, for implantation Within the body.
4. A receiver-stimulator according to claim 3 further characterized in that said receiver includes a radio frequency tuned tank circuit, the inductor of said tank circuit being an antenna for an external radio frequency signal.
S. A receiver-stimulator according to claim 3 further characterized in that said receiver includes an output coupling capacitor to block the flow of direct current to said electrodes.
6. A receiver-stimulator according to claim 5 further characterized in that said receiver includes means for adapting said receiver to be powered by an external high power radio frequency generator and includes a rectifier for imparting unidirectional ow to the electrical stimulus to said electrodes and a filter to block the ow of radio frequency current.
7. A volitional receiver-stimulator for the stimulation of a distended bladder to cause emptying thereof intermittently at widely spaced time intervals dictated by liquid intake into said bladder, said stimulator including (A) a radio frequency receiver,
(B) at least two separate electrode means for direct attachment to the bladder walls at variable relatively widely spaced distances,
(C) flexible electrical conductor means connecting said receiver and electrode means,
(D) means within said receiver for altering an externally transmitted radio frequency signal and applying a pulsing electrical stimulus to the bladder wall through said electrode means,
(E) means for applying said pulsing electrical stimulus for short time intervals suicient to substantially empty said bladder at Widely spaced time intervals dictated by liquid intake into said bladder,
(F) said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively at wafer-like envelope and elongated eXible sheaths, respectively, for implanting Within the body.
8. A volitional receiver-stimulator for the stimulation of a distended bladder to cause emptying thereof intermittently at widely spaced time intervals dictated by liquid intake into said bladder, said stimulator including (A) a radio frequency receiver,
(B) at least two separate electrode means for direct attachment to the bladder Walls at variable relatively widely spaced distances,
(C) tleXible electrical conductor means connecting said receiver and electrode means,
(D) means within said receiver for altering an externally transmitted radio frequency signal and applying a pulsing electrical stimulus to the bladder wall through said electrode means including:
(1) a tuned tank circuit, the inductor which serves as an antenna for an externally generated high power radio frequency signal,
(2) a rectifier for imparting unidirectional flow t0 the electrical stimulus to said electrode means,
(3) a filter to block the flow of radio frequency current, and
(4) an output coupling capacitor to block the tlow of direct current to said electrode means,
(E) means for applying said pulsing electrical stimulus for short time intervals sufficient to substantially empty said bladder at widely spaced time intervals dictated by liquid intake to said bladder,
(F) said receiver and conductor means being encased in an inert non-toxic and non-irritant protective material in a relatively llat Wafer-like envelope and elongated flexible sheaths, respectively, for implanting Within the body.
9. A volitional method for artificially causing a distended bladder to be emptied intermittently at widely spaced time intervals dictated by liquid intake into said bladder, which method comprises the steps of (A) mplanting a means for producing electrical stimuli within the body,
(B) connecting said means directly to the bladder Wall at at least two relatively widely spaced contact areas on opposite sides thereof,
(C) actuating said electrical stimulus producing means implanted within the body from externally of the body for short time intervals suicient to substantially empty said bladder intermittently at relatively widely spaced time intervals dictated by liquid intake into said bladder,
(D) thereby applying pulsing electrical stimuli directly to the bladder wall for said short time intervals at said relatively widely spaced time intervals to contract the bladder Wall and empty the contents thereof,
(E) said stimuli having an amplitude of about 1 to 50 volts and a pulse recurrence frequency of the order of about 20 to 2000 cycles per second, said frequency being up to about 20 times the pulse duration.
References Cited by the Examiner UNITED STATES PATENTS 623,022 4/1899 Johnson 12S-407 1,056,336 3/1913 Hurdrnan 128-407 3,050,695 8/1962 Du Vall 12S-421 X 3,057,344- 10/ 1962 Abella 12S-2 3,057,356 10/ 1962 Greatbatch 12S- 422 OTHER REFERENCES Schamaun, pp. 640-650 of Surgery, October 1963. Kantrowitz, pp. 595-597 of JAMA, Feb. 22, 1964.
RICHARD A. GAUDET, Primary Examiner. JORDAN FRANKLIN, Examiner.
Claims (1)
1. A VOLITIONAL STIMULATOR FOR THE STIMULATION OF A DISTENDED BLADDER TO CAUSE THE EMPTYING THEREOF INTERMITTENTLY AT WIDELY SPACED LINE INTERVALS DICTATED BY LIQUID INTAKE INTO THE BLADDER, SAID STIMULATOR INCLUDING (A) MEANS FOR PRODUCING CONTROLLABLE INTERMITTENT ELECTRICAL STIMULI HAVING AN AMPLITUDE OF ABOUT 1 TO 50 VOLTS AND A PULSE RECURRENCE FREQUENCY OF THE ORDER OF ABOUT 20 TO 2000 CYCLES PER SECOND, SAID FREQUENCY BEING UP TO ABOUT 20 TIMES THE PULSE DURATION, (B) AT LEAST TWO SEPARATE ELECTRODE MEANS FOR DIRECT ATTACHMENT OT THE BLADDER WALL AT VARIABLE RELATIVELY WIDELY SPACED DISTANCES, (C) FLEXIBLE ELECTRICAL CONDUCTOR MEANS CONNECTING SAID ELECTRODE MEANS TO SAID MEANS FOR PRODUCING ELECTRICAL STIMULI, (D) MEANS FOR ACTUATING SAID MEANS FOR PRODUCING FOR ELECTRICAL STIMULI TO TURN SAID MEANS "ON" TO APPLY A PULSING ELECTRICAL STIMULUS TO THE BLADDER WALL THROUGH SAID ELECTRODE MEANS, (E) MEANS FOR MANUALLY CONTROLLING SAID ACTUATING MEANS FOR APPLYING SAID STIMULUS FOR A SHORT TIME INTERVAL SUFFICIENT TO SUBSTANTIALLY EMPTY SAID BLADDER INTERMITTENTLY AT SAID WIDELY SPACED TIME INTERVALS DICATED BY LIQUID INTAKE INTO THE BLADDER, (F) SAID MEANS FOR PRODUCING ELECTRICAL STIMULI AND SAID CONDUCTOR MEANS BEING ENCASED IN AN INERT NONTOXIC AND NON-IRRITANT PROTECTIVE MATERIAL IN A RELATIVELY FLAT WAFER-LIKE ENVELOPE AND ELONGATED FLEXIBLE SHEATHS, RESPECTIVELY, FOR IMPLANTATION WITH THE BODY.
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| Application Number | Priority Date | Filing Date | Title |
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| US221754A US3236240A (en) | 1962-09-06 | 1962-09-06 | Implantable bladder stimulator |
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|---|---|---|---|
| US221754A US3236240A (en) | 1962-09-06 | 1962-09-06 | Implantable bladder stimulator |
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| US3236240A true US3236240A (en) | 1966-02-22 |
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Cited By (27)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3313289A (en) * | 1964-06-23 | 1967-04-11 | Frank A Kapral | Implant chamber |
| US3363619A (en) * | 1965-03-29 | 1968-01-16 | Walter A. Keitzer | Voiding audiograph and method of using same |
| US3646940A (en) * | 1969-07-15 | 1972-03-07 | Univ Minnesota | Implantable electronic stimulator electrode and method |
| US3662758A (en) * | 1969-06-30 | 1972-05-16 | Mentor Corp | Stimulator apparatus for muscular organs with external transmitter and implantable receiver |
| US3667477A (en) * | 1966-11-25 | 1972-06-06 | Canadian Patents Dev | Implantable vesical stimulator |
| US3727616A (en) * | 1971-06-15 | 1973-04-17 | Gen Dynamics Corp | Electronic system for the stimulation of biological systems |
| US3870051A (en) * | 1972-04-27 | 1975-03-11 | Nat Res Dev | Urinary control |
| US3941136A (en) * | 1973-11-21 | 1976-03-02 | Neuronyx Corporation | Method for artificially inducing urination, defecation, or sexual excitation |
| WO1984003211A1 (en) * | 1983-02-28 | 1984-08-30 | Joel S Hochman | A device for the development, training and rehabilitation of the pubococcygeal and related perineal musculature of the female |
| US4499900A (en) * | 1982-11-26 | 1985-02-19 | Wright State University | System and method for treating paralyzed persons |
| US4603697A (en) * | 1985-01-07 | 1986-08-05 | William Kamerling | System for preventing or treating open angle glaucoma and presbyopia |
| US4612934A (en) * | 1981-06-30 | 1986-09-23 | Borkan William N | Non-invasive multiprogrammable tissue stimulator |
| US4793353A (en) * | 1981-06-30 | 1988-12-27 | Borkan William N | Non-invasive multiprogrammable tissue stimulator and method |
| US5105811A (en) * | 1982-07-27 | 1992-04-21 | Commonwealth Of Australia | Cochlear prosthetic package |
| WO1993009841A1 (en) * | 1991-11-18 | 1993-05-27 | Cyberonics, Inc. | Activation techniques for implantable medical device |
| US5291902A (en) * | 1993-01-11 | 1994-03-08 | Brent Carman | Incontinence treatment |
| WO1996028211A1 (en) * | 1995-03-13 | 1996-09-19 | Osbon Medical Systems | Therapy apparatus for the functional electromyostimulation of smooth muscle cells |
| US5716385A (en) * | 1996-11-12 | 1998-02-10 | University Of Virginia | Crural diaphragm pacemaker and method for treating esophageal reflux disease |
| US20050055063A1 (en) * | 2001-07-20 | 2005-03-10 | Loeb Gerald E. | Method and apparatus for the treatment of urinary tract dysfunction |
| US20060217785A1 (en) * | 2005-03-24 | 2006-09-28 | Eusebiu Matei | Implantable device for controlling received power by a power receiving unit therein |
| WO2009080786A3 (en) * | 2007-12-21 | 2009-09-11 | Neurodan A/S | Mechanical control of electrical nerve stimulation system for the treatment of pelvic disorders |
| US8214048B1 (en) * | 2000-08-18 | 2012-07-03 | Boston Scientific Neuromodulation Corporation | Fully implantable neurostimulator for autonomic nerve fiber stimulation as a therapy for urinary and bowel dysfunction |
| EP2587275A1 (en) * | 2006-12-22 | 2013-05-01 | Koninklijke Philips Electronics N.V. | Catheter for MRI-guided cardiac pacing |
| WO2017024136A1 (en) * | 2015-08-05 | 2017-02-09 | Boston Scientific Scimed, Inc. | Control of bladder function using high frequency pacing |
| EP3251586A1 (en) | 2016-05-30 | 2017-12-06 | ETH Zurich | Implantable analgoue device and system comprising such device |
| WO2020185734A1 (en) * | 2019-03-11 | 2020-09-17 | Regents Of The University Of Minnesota | Systems and methods for combined ultrasound and electrical stimulation for treating a subject |
| USD940890S1 (en) * | 2019-11-06 | 2022-01-11 | Neuvana, Llc | Portable electronic device |
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| US3057344A (en) * | 1957-05-21 | 1962-10-09 | Abella Carlos Alberto | Capsule for the study of the digestive tract and method of using the same |
| US3050695A (en) * | 1959-09-10 | 1962-08-21 | W W Henry Co Inc | Pulse generator for human treatment |
| US3057356A (en) * | 1960-07-22 | 1962-10-09 | Wilson Greatbatch Inc | Medical cardiac pacemaker |
Cited By (39)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3313289A (en) * | 1964-06-23 | 1967-04-11 | Frank A Kapral | Implant chamber |
| US3363619A (en) * | 1965-03-29 | 1968-01-16 | Walter A. Keitzer | Voiding audiograph and method of using same |
| US3667477A (en) * | 1966-11-25 | 1972-06-06 | Canadian Patents Dev | Implantable vesical stimulator |
| US3662758A (en) * | 1969-06-30 | 1972-05-16 | Mentor Corp | Stimulator apparatus for muscular organs with external transmitter and implantable receiver |
| US3646940A (en) * | 1969-07-15 | 1972-03-07 | Univ Minnesota | Implantable electronic stimulator electrode and method |
| US3727616A (en) * | 1971-06-15 | 1973-04-17 | Gen Dynamics Corp | Electronic system for the stimulation of biological systems |
| US3870051A (en) * | 1972-04-27 | 1975-03-11 | Nat Res Dev | Urinary control |
| US3941136A (en) * | 1973-11-21 | 1976-03-02 | Neuronyx Corporation | Method for artificially inducing urination, defecation, or sexual excitation |
| US4612934A (en) * | 1981-06-30 | 1986-09-23 | Borkan William N | Non-invasive multiprogrammable tissue stimulator |
| US4793353A (en) * | 1981-06-30 | 1988-12-27 | Borkan William N | Non-invasive multiprogrammable tissue stimulator and method |
| US5105811A (en) * | 1982-07-27 | 1992-04-21 | Commonwealth Of Australia | Cochlear prosthetic package |
| US4499900A (en) * | 1982-11-26 | 1985-02-19 | Wright State University | System and method for treating paralyzed persons |
| WO1984003211A1 (en) * | 1983-02-28 | 1984-08-30 | Joel S Hochman | A device for the development, training and rehabilitation of the pubococcygeal and related perineal musculature of the female |
| US4515167A (en) * | 1983-02-28 | 1985-05-07 | Hochman Joel S | Device for the development, training and rehabilitation of the pubococcygeal and related perineal musculature of the female |
| US4603697A (en) * | 1985-01-07 | 1986-08-05 | William Kamerling | System for preventing or treating open angle glaucoma and presbyopia |
| EP0613389A1 (en) * | 1991-11-18 | 1994-09-07 | Cyberonics, Inc. | Activation techniques for implantable medical device |
| US5304206A (en) * | 1991-11-18 | 1994-04-19 | Cyberonics, Inc. | Activation techniques for implantable medical device |
| WO1993009841A1 (en) * | 1991-11-18 | 1993-05-27 | Cyberonics, Inc. | Activation techniques for implantable medical device |
| AU666901B2 (en) * | 1991-11-18 | 1996-02-29 | Cyberonics, Inc. | Activation techniques for implantable medical device |
| EP0613389A4 (en) * | 1991-11-18 | 1996-04-03 | Cyberonics Inc | Activation techniques for implantable medical device. |
| US5291902A (en) * | 1993-01-11 | 1994-03-08 | Brent Carman | Incontinence treatment |
| WO1996028211A1 (en) * | 1995-03-13 | 1996-09-19 | Osbon Medical Systems | Therapy apparatus for the functional electromyostimulation of smooth muscle cells |
| US6128536A (en) * | 1995-03-13 | 2000-10-03 | Medizintechnik Dipl.-Ing. Heise Vertriebs Gmbh | Therapy apparatus for the functional electromyostimulation of smooth muscle cells |
| US5716385A (en) * | 1996-11-12 | 1998-02-10 | University Of Virginia | Crural diaphragm pacemaker and method for treating esophageal reflux disease |
| US8214048B1 (en) * | 2000-08-18 | 2012-07-03 | Boston Scientific Neuromodulation Corporation | Fully implantable neurostimulator for autonomic nerve fiber stimulation as a therapy for urinary and bowel dysfunction |
| US8588917B2 (en) | 2000-08-18 | 2013-11-19 | Boston Scientific Neuromodulation Corporation | Fully implantable neurostimulator for autonomic nerve fiber stimulation as a therapy for urinary and bowel dysfunction |
| US20050055063A1 (en) * | 2001-07-20 | 2005-03-10 | Loeb Gerald E. | Method and apparatus for the treatment of urinary tract dysfunction |
| US7565204B2 (en) * | 2005-03-24 | 2009-07-21 | Alfred E. Mann Foundation For Scientific Research | Implantable device for controlling received power by a power receiving unit therein |
| US20060217785A1 (en) * | 2005-03-24 | 2006-09-28 | Eusebiu Matei | Implantable device for controlling received power by a power receiving unit therein |
| EP2587275A1 (en) * | 2006-12-22 | 2013-05-01 | Koninklijke Philips Electronics N.V. | Catheter for MRI-guided cardiac pacing |
| WO2009080786A3 (en) * | 2007-12-21 | 2009-09-11 | Neurodan A/S | Mechanical control of electrical nerve stimulation system for the treatment of pelvic disorders |
| WO2017024136A1 (en) * | 2015-08-05 | 2017-02-09 | Boston Scientific Scimed, Inc. | Control of bladder function using high frequency pacing |
| CN107743408A (en) * | 2015-08-05 | 2018-02-27 | 波士顿科学医学有限公司 | Control bladder function is paced using high frequency |
| JP2018519935A (en) * | 2015-08-05 | 2018-07-26 | ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． | Control of bladder function using radio frequency pacing |
| US10441785B2 (en) | 2015-08-05 | 2019-10-15 | Boston Scientific Scimed, Inc. | Control of bladder function using high frequency pacing |
| CN107743408B (en) * | 2015-08-05 | 2021-01-08 | 波士顿科学医学有限公司 | Bladder function control using high frequency pacing |
| EP3251586A1 (en) | 2016-05-30 | 2017-12-06 | ETH Zurich | Implantable analgoue device and system comprising such device |
| WO2020185734A1 (en) * | 2019-03-11 | 2020-09-17 | Regents Of The University Of Minnesota | Systems and methods for combined ultrasound and electrical stimulation for treating a subject |
| USD940890S1 (en) * | 2019-11-06 | 2022-01-11 | Neuvana, Llc | Portable electronic device |
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