US3817254A - Transcutaneous stimulator and stimulation method - Google Patents

Transcutaneous stimulator and stimulation method Download PDF

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US3817254A
US3817254A US25128072A US3817254A US 3817254 A US3817254 A US 3817254A US 25128072 A US25128072 A US 25128072A US 3817254 A US3817254 A US 3817254A
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pulses
stimulator
means
substantially
transcutaneous
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D Maurer
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Medtronic Inc
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Medtronic Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014External stimulators, e.g. with patch electrodes
    • A61N1/36021External stimulators, e.g. with patch electrodes for treatment of pain

Abstract

A transcutaneous stimulator for stimulating portions of the body. The output of the stimulator is a stimulating pulse having frequency components falling within predetermined frequency band limits so as to optimally excite touch nerve fibres relative to nociceptor or pain receptor nerve fibres.

Description

United States Patent 1191 Maurer June 18 1974 TRANSCUTANEOUS STIMULATOR AND 2,771,554 11/1956 Gratz 128/421 STIMULATION METHOD FOREIGN PATENTS OR APPLICATIONS [75] Inventor: Donald Mamr Anoka, 1,088,607 10/1967 Great Brita.in..... 123/1 c [73] Assignee: Medtronic, Inc., Minneapolis, Minn. V

Primary Examiner-William E. Kamm [22] May 1972 Attorney, Agent, or FirmLew Schwartz; Wayne A. [21] Appl. No.: 251,280 Sivemon [52] US. Cl. 128/421 57 ABSTRACT [51] Int. Cl A6ln 1/36 [58} Field of Search 128/1 0, 2.1 R, 419 c, A transcutaneous snmulator fi stlmulafimg PP 128/419 E 419 R 420 421 422 423 of the body. The output of the stlmulator 1s a Stnnulating pulse having frequency components falling within [56] References Cited predetermined frequency band limits so as tooptimally excite touch nerve fibres relative to nociceptor UNITED STATES PATENTS or pain receptor nerve fibres. 1,908,688 5/1933 Call 128/420 2,764,683 9/1956 Daust et al 128/423 8 Claims, 2 Drawing Figures 211251 f ,7 1 1 PULSE GENERATOR FILTER AND CURRENT T 12- CONTROL 1a PATENTEBJII 18 874 HSNOdSSH HALLVIEIHI TRANSCUTANEOUS STIMULA'IOR AND STIMULATION METHOD BACKGROUND OF THEINVENTION Peripheral nerve fibres have been classified in order of decreasing size and conduction velocity in a manner which is now standardized. Generally, as the fibre size decreases, the amplitude of electrical stimulation required to elicit an action potential increases. Also, the smaller fibre will require longer pulse durations than large fibre stimuli. These differences in nerve response have been used to selectively stimulate different types of nerve fibres by varying the amplitude, pulse duration, or pulse repetition rate of an electrical stimulating pulse. The desired degree of nerve fibre selectivity, however, has not been achieved in the prior art, with the result that, for example, an elicited touch response resulting from the stimulating pulse is often accompanied by a prickly, stinging, burning, sharp or other unpleasant noxious response.

SUMMARY OF THE INVENTION The present invention provides a stimulating pulse having frequency components falling within predeterters. The type of stimulation specified herein, optimizes the differential excitation between touch and pain specific fibres, thus optimizing the inhibition of pain transmission.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram of a transcutaneous stimulator embodying the present invention. l I

FIG. 2 is a graph of touch and pain response versus frequency. 1 1

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT There is an increasing interest in external electrical skin stimulation for such purposes as pain suppression, neuro-muscular stimulation, communication systems, etcetera. The preferred embodiment of the present invention as described herein, is directed particularly at a transcutaneous stimulator for the suppression of organic pain, although it has obvious applications beyond this particular field. In understanding the present invention, the prior art devices shown in US. Patent Nos. 1,059,090 and No. 1,305,725 should be mentioned. These devices, are essentially pulse generators which have the capacity to suppress organic pain when applied to the body in proper relation to the nervous system. Along with the organic pain suppression, however, there is a concurrent noxious sensation producedby the stimulation which, over a period of time, may become more distracting that the organic pain being suppressed. Prior art attempts to eliminate this noxious sensation have included variations in the pulse amplitude, pulse duration, and pulse repetition rate. To an extent, these approaches have provided some success v but, in their success, have limited the application of the technique by placing very restrictive parameters on its operation.

The present invention can best be understood by viewing the pulses used in the prior art devices in terms of a Fourier transform analysis. Any pulse has a fundamental sine wave component. Non-sine wave pulses, in addition, have sine wave components having frequencies which are multiples of the fundamental frequency. By determining which of these frequency components operate on which of the various nerve classifications, it is possible to generate a signal whose frequency components fall within predetermined frequency band limits, thus reducing the undesired noxious sensation. Peripheral nerve fibres have a standard classification in order of decreasing size and conduction velocity. Those of particular interest here are the class A-beta fibres which :subserve touch and the class C fibres which are specific for pain. In addition, it has been demonstrated that the differential excitation of the A- beta fibres with respect to the C fibres will inhibit the transmission of pain information from the class C wave pulse. The pulse generator 10 is provided with a pulse rate control 11 which operates in a known manner. The output of the pulse generator 10 is transmitted by line 12 to a low pass active filter which may be one of a number of known types. Dependent upon the output of the pulse generator 10, the low pass filter 13 will produce a full or half wave pulse of a single frequency or having a plurality of frequency components within the bonds to be described hereinafter. The filtered wave is passed from the filter 13 over the line 14 to a power amplifier and current control 15 whose output is coupled to the output electrodes 17 and 18 by a conventional transformer 20. Either or both of the electrodes which are directly attached to the body may be of a type disclosed in my copending application, Ser. No. 251,179 filed May 8, 1972;, for Electrode for Transcutaneous Stimulator. A feedback line'Zl is employed to introduce a constant current feature to the stimulator of the present invention. In addition, in some applications it may prove necessary to vary the pulse repetition rate to overcome nerve adaption. This can be accomplished by providing a ramp generator as an input to the pulse generator 10 in any known manner.

Referring now to FIG. 2, there is shown a plot of touch and pain response versus frequency. The touch response curve 23 is essentially a bellshaped curve which results from direct electrical stimulation. Curve 24 shows the pain response curve with segments A, B and C. Segments A and C result from secondary effects of the stimulation, such as, for example, chemical effects Segment B results from both the secondary effects and the effect of direct electrical stimulation. A greater differential excitation of touch nerve fibres over pain nerve fibres will inhibit the transmission of a pain signal from the pain fibres. Any specific frequency of stimulation which elicits a greater touch response than pain response will inhibit the pain transmission thereby eliminating any noxious sensation from the stimulation. An

3 example of such a frequency is indicated in FIG. 2 at X.

Similarly, any pulse having individual frequency components which collectively elicit a greater touch response than pain response will inhibit pain transmission and eliminate any noxious sensation from the stimulation.

l have discovered that a substantially pure sine wave pulse, either full or half wave, within the range of substantially 1,000-3 ,000 Hz produces a greater touch response than pain response thereby eliminating any noxious sensation. Similarly, a stimulation pulse having a plurality of frequency components and substantially 90 percent of its energy falling within the predetermined frequency band limits of substantially IOU-5,000 Hz with the fundamental frequency preferably within the range of substantially l,000-3,000 Hz will produce a greater touch response than pain response thereby eliminating any noxious sensations.

Obviously, many modifications and variations of the present invention are possible in light of the above teaching. Specifically, there are many alternative ways of generating the optimized waveforms disclosed herein which do not depart from the intended scope of the application. For example, a frequency synthesizer could be employed in place of the pulse generator and filter 13. Accordingly, it is to be understood that, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.

[ claim:

1. A stimulator adapted for use as a transcutaneous stimulator for the purpose of organic pain suppression which comprises:

pulse generator means;

filter means for transforming the pulses of the pulse generator means into output pulses each comprising a plurality of frequency components having substantially percent of their energy throughout substantially -5 ,000 Hz; and

output means connected to said filter means for applying said transformed pulses transcutaneously.

2. The stimulator of claim 1 wherein the transformed pulses are full cycle pulses.

3. The stimulator of claim 1 wherein the transformed pulses are half cycle pulses.

4. The stimulator of claim 1 wherein said output means further comprises constant current means for regulating the current output of said filter means.

- 5. A transcutaneous stimulator which comprises:

means for producing a series of pulses, each of said pulses having frequency components substantially 90 percent of the energy of which falls within substantially 100-5,000 Hz and output means connected to said pulse series producapplying the pulses to the portion of the body.

Claims (8)

1. A stimulator adapted for use as a transcutaneous stimulator for the purpose of organic pain suppression which comprises: pulse generator means; filter means for transforming the pulses of the pulse generator means into output pulses each comprising a plurality of frequency components having substantially 90 percent of their energy throughout substantially 100-5,000 Hz; and output means connected to said filter means for applying said transformed pulses transcutaneously.
2. The stimulator of claim 1 wherein the transformed pulses are full cycle pulses.
3. The stimulator of claim 1 wherein the transformed pulses are half cycle pulses.
4. The stimulator of claim 1 wherein said output means further comprises constant current means for regulating the current output of said filter means.
5. A transcutaneous stimulator which comprises: means for producing a series of pulses, each of said pulses having frequency components substantially 90 percent of the energy of which falls within substantially 100-5,000 Hz and output means connected to said pulse series producing means.
6. The transcutaneous stimulator of claim 5 wherein the pulses are full cycle pulses.
7. The transcutaneous stimulator of claim 5 wherein the pulses are half cycle pulses.
8. A method of transcutaneous stimulation which comprises the steps of: producing a series of pulses, each of said pulses comprising a plurality of frequency components having substantially 90 percent of their energy throughout substantially 100-5,000 Hz; and applying the pulses to the portion of the body.
US3817254A 1972-05-08 1972-05-08 Transcutaneous stimulator and stimulation method Expired - Lifetime US3817254A (en)

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US3817254A US3817254A (en) 1972-05-08 1972-05-08 Transcutaneous stimulator and stimulation method
CA 169827 CA1010508A (en) 1972-05-08 1973-04-30 Transcutaneous stimulator
GB2168373A GB1422845A (en) 1972-05-08 1973-05-07 Transcutaneous stimulator
DE19732322953 DE2322953A1 (en) 1972-05-08 1973-05-07 Reizstromgeraet
JP5054173A JPS502388A (en) 1972-05-08 1973-05-07
FR7316391A FR2183891B1 (en) 1972-05-08 1973-05-07
NL7306338A NL7306338A (en) 1972-05-08 1973-05-07

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DE (1) DE2322953A1 (en)
FR (1) FR2183891B1 (en)
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US3902502A (en) * 1974-09-13 1975-09-02 Saul Liss Apparatus for temporarily arresting arthritic pain
US3911930A (en) * 1974-03-01 1975-10-14 Stimulation Tech Method and structure of preventing and treating ileus, and reducing acute pain by electrical pulse stimulation
US4068669A (en) * 1975-11-24 1978-01-17 Stimulation Technology, Inc. Stimulator fault protection circuit
US4121594A (en) * 1977-09-26 1978-10-24 Med General, Inc. Transcutaneous electrical nerve stimulator
US4167189A (en) * 1976-04-26 1979-09-11 Agency Of Industrial Science & Technology Apparatus for transmission of information by electrocutaneous stimulus
US4249537A (en) * 1979-05-18 1981-02-10 Chaconas Charles G Current controlled muscle stimulator
US4305402A (en) * 1979-06-29 1981-12-15 Katims Jefferson J Method for transcutaneous electrical stimulation
US4324253A (en) * 1977-01-28 1982-04-13 Greene Ronald W Transcutaneous pain control and/or muscle stimulating apparatus
US4340063A (en) * 1980-01-02 1982-07-20 Empi, Inc. Stimulation device
US4421336A (en) * 1982-09-14 1983-12-20 Wright State University Vehicle for the paralyzed
EP0099662A1 (en) * 1982-07-15 1984-02-01 John Kenneth Wilmot Transcutaneous electrical nerve stimulation apparatus
US4431002A (en) * 1981-06-08 1984-02-14 Empi Inc. Modulated deep afferent stimulator
EP0103491A1 (en) * 1982-09-14 1984-03-21 Wright State University Method and apparatus for providing feedback-controlled muscle stimulation
US4442839A (en) * 1981-04-27 1984-04-17 Empi, Inc. Method of modulating energy in train of electrical pulses
EP0111229A2 (en) * 1982-12-08 1984-06-20 Neurotronic (1981) Ltee. Electric nerve stimulator device
US4480830A (en) * 1982-09-14 1984-11-06 Wright State University Method and apparatus for exercising
US4499900A (en) * 1982-11-26 1985-02-19 Wright State University System and method for treating paralyzed persons
US4503863A (en) * 1979-06-29 1985-03-12 Katims Jefferson J Method and apparatus for transcutaneous electrical stimulation
US4556214A (en) * 1982-09-14 1985-12-03 Wright State University Method and apparatus for exercising
US4917092A (en) * 1988-07-13 1990-04-17 Medical Designs, Inc. Transcutaneous nerve stimulator for treatment of sympathetic nerve dysfunction
US4919140A (en) * 1988-10-14 1990-04-24 Purdue Research Foundation Method and apparatus for regenerating nerves
WO1991019535A1 (en) * 1990-06-12 1991-12-26 Zmd Corporation Method and apparatus for transcutaneous cardiac pacing
US5193537A (en) * 1990-06-12 1993-03-16 Zmd Corporation Method and apparatus for transcutaneous electrical cardiac pacing
US6205359B1 (en) 1998-10-26 2001-03-20 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6208902B1 (en) 1998-10-26 2001-03-27 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for pain syndromes utilizing an implantable lead and an external stimulator
US6269270B1 (en) 1998-10-26 2001-07-31 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of Dementia and Alzheimer's disease utilizing an implantable lead and external stimulator
US6309406B1 (en) 1999-11-24 2001-10-30 Hamit-Darwin-Fresh, Inc. Apparatus and method for inducing epileptic seizures in test animals for anticonvulsant drug screening
US20040015203A1 (en) * 2000-05-08 2004-01-22 Mcgraw Michael B. Multi-functional portable electro-medical device
US20040167589A1 (en) * 2003-02-22 2004-08-26 Chester Heath Viral-inhibiting apparatus and methods
US20070038263A1 (en) * 2005-07-11 2007-02-15 Mcintyre Jon T Percutaneous access for neuromodulation procedures
US20070073354A1 (en) * 2005-09-26 2007-03-29 Knudson Mark B Neural blocking therapy
US20070167990A1 (en) * 2006-01-17 2007-07-19 Theranova, Llc Method and apparatus for low frequency induction therapy for the treatment of urinary incontinence and overactive bladder
US20070213771A1 (en) * 2006-03-07 2007-09-13 Spinner Robert J Regional anesthetic
USRE40279E1 (en) 1997-06-26 2008-04-29 Sherwood Services Ag Method and system for neural tissue modification
US20080208287A1 (en) * 2007-02-27 2008-08-28 Palermo Francis X Electrical stimulation device and method for the treatment of neurological disorders
US20090132003A1 (en) * 2005-10-21 2009-05-21 Purdue Research Foundation Wireless Electrical Stimulation of Neural Injury
US20090204173A1 (en) * 2007-11-05 2009-08-13 Zi-Ping Fang Multi-Frequency Neural Treatments and Associated Systems and Methods
US20090254148A1 (en) * 2005-10-21 2009-10-08 Borgens Richard B Telemetrically Controllable System for Treatment of Nervous Sytem Injury
USRE41045E1 (en) 1996-06-27 2009-12-15 Covidien Ag Method and apparatus for altering neural tissue function
US20100274316A1 (en) * 2009-04-22 2010-10-28 Konstantinos Alataris Devices for controlling high frequency spinal cord modulation for inhibiting pain, and associated systems and methods, including simplified controllers
US20110230938A1 (en) * 2009-03-20 2011-09-22 ElectroCore, LLC. Device and methods for non-invasive electrical stimulation and their use for vagal nerve stimulation
US20110230701A1 (en) * 2009-03-20 2011-09-22 ElectroCore, LLC. Electrical and magnetic stimulators used to treat migraine/sinus headache and comorbid disorders
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Cited By (142)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3911930A (en) * 1974-03-01 1975-10-14 Stimulation Tech Method and structure of preventing and treating ileus, and reducing acute pain by electrical pulse stimulation
US3902502A (en) * 1974-09-13 1975-09-02 Saul Liss Apparatus for temporarily arresting arthritic pain
US4068669A (en) * 1975-11-24 1978-01-17 Stimulation Technology, Inc. Stimulator fault protection circuit
US4167189A (en) * 1976-04-26 1979-09-11 Agency Of Industrial Science & Technology Apparatus for transmission of information by electrocutaneous stimulus
US4324253A (en) * 1977-01-28 1982-04-13 Greene Ronald W Transcutaneous pain control and/or muscle stimulating apparatus
US4121594A (en) * 1977-09-26 1978-10-24 Med General, Inc. Transcutaneous electrical nerve stimulator
US4249537A (en) * 1979-05-18 1981-02-10 Chaconas Charles G Current controlled muscle stimulator
US4503863A (en) * 1979-06-29 1985-03-12 Katims Jefferson J Method and apparatus for transcutaneous electrical stimulation
US4305402A (en) * 1979-06-29 1981-12-15 Katims Jefferson J Method for transcutaneous electrical stimulation
US4340063A (en) * 1980-01-02 1982-07-20 Empi, Inc. Stimulation device
US4442839A (en) * 1981-04-27 1984-04-17 Empi, Inc. Method of modulating energy in train of electrical pulses
US4431002A (en) * 1981-06-08 1984-02-14 Empi Inc. Modulated deep afferent stimulator
EP0099662A1 (en) * 1982-07-15 1984-02-01 John Kenneth Wilmot Transcutaneous electrical nerve stimulation apparatus
US4421336A (en) * 1982-09-14 1983-12-20 Wright State University Vehicle for the paralyzed
US4556214A (en) * 1982-09-14 1985-12-03 Wright State University Method and apparatus for exercising
EP0103491A1 (en) * 1982-09-14 1984-03-21 Wright State University Method and apparatus for providing feedback-controlled muscle stimulation
US4480830A (en) * 1982-09-14 1984-11-06 Wright State University Method and apparatus for exercising
US4492233A (en) * 1982-09-14 1985-01-08 Wright State University Method and apparatus for providing feedback-controlled muscle stimulation
US4499900A (en) * 1982-11-26 1985-02-19 Wright State University System and method for treating paralyzed persons
EP0111229A2 (en) * 1982-12-08 1984-06-20 Neurotronic (1981) Ltee. Electric nerve stimulator device
EP0111229A3 (en) * 1982-12-08 1984-07-25 Neurotronic (1981) Ltee. Electric nerve stimulator device
US4917092A (en) * 1988-07-13 1990-04-17 Medical Designs, Inc. Transcutaneous nerve stimulator for treatment of sympathetic nerve dysfunction
US4919140A (en) * 1988-10-14 1990-04-24 Purdue Research Foundation Method and apparatus for regenerating nerves
US5205284A (en) * 1990-06-12 1993-04-27 Zoll Medical Corporation Method and apparatus for transcutaneous electrical cardiac pacing with background stimulation
WO1991019535A1 (en) * 1990-06-12 1991-12-26 Zmd Corporation Method and apparatus for transcutaneous cardiac pacing
US5193537A (en) * 1990-06-12 1993-03-16 Zmd Corporation Method and apparatus for transcutaneous electrical cardiac pacing
US5282843A (en) * 1990-06-12 1994-02-01 Zmd Corporation Electrodes and method for transcutaneous cardiac pacing
USRE41045E1 (en) 1996-06-27 2009-12-15 Covidien Ag Method and apparatus for altering neural tissue function
USRE40279E1 (en) 1997-06-26 2008-04-29 Sherwood Services Ag Method and system for neural tissue modification
US6269270B1 (en) 1998-10-26 2001-07-31 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of Dementia and Alzheimer's disease utilizing an implantable lead and external stimulator
US6208902B1 (en) 1998-10-26 2001-03-27 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for pain syndromes utilizing an implantable lead and an external stimulator
US6205359B1 (en) 1998-10-26 2001-03-20 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy of partial complex epilepsy, generalized epilepsy and involuntary movement disorders utilizing an external stimulator
US6309406B1 (en) 1999-11-24 2001-10-30 Hamit-Darwin-Fresh, Inc. Apparatus and method for inducing epileptic seizures in test animals for anticonvulsant drug screening
US20040015203A1 (en) * 2000-05-08 2004-01-22 Mcgraw Michael B. Multi-functional portable electro-medical device
US6988005B2 (en) 2000-05-08 2006-01-17 International Rehabilitative Sciences, Inc. Multi-functional portable electro-medical device
US20040167589A1 (en) * 2003-02-22 2004-08-26 Chester Heath Viral-inhibiting apparatus and methods
US20070073372A1 (en) * 2003-02-22 2007-03-29 Chester Heath Viral-inhibiting apparatus and methods
US20070038263A1 (en) * 2005-07-11 2007-02-15 Mcintyre Jon T Percutaneous access for neuromodulation procedures
US7415309B2 (en) * 2005-07-11 2008-08-19 Boston Scientific Scimed, Inc. Percutaneous access for neuromodulation procedures
US20070073354A1 (en) * 2005-09-26 2007-03-29 Knudson Mark B Neural blocking therapy
US20080154333A1 (en) * 2005-09-26 2008-06-26 Venturi Group, Llc Neural blocking therapy
US8798754B2 (en) 2005-09-26 2014-08-05 Venturi Group, Llc Neural blocking therapy
US20090254148A1 (en) * 2005-10-21 2009-10-08 Borgens Richard B Telemetrically Controllable System for Treatment of Nervous Sytem Injury
US20090132003A1 (en) * 2005-10-21 2009-05-21 Purdue Research Foundation Wireless Electrical Stimulation of Neural Injury
US20070167990A1 (en) * 2006-01-17 2007-07-19 Theranova, Llc Method and apparatus for low frequency induction therapy for the treatment of urinary incontinence and overactive bladder
US9002477B2 (en) 2006-01-17 2015-04-07 Emkinetics, Inc. Methods and devices for performing electrical stimulation to treat various conditions
US9630004B2 (en) 2006-01-17 2017-04-25 Emkinetics, Inc. Method and apparatus for transdermal stimulation over the palmar and plantar surfaces
US20100222630A1 (en) * 2006-01-17 2010-09-02 Emkinetics, Inc. Method and apparatus for low frequency induction therapy for the treatment of urinary incontinence and overactive bladder
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