Abstract: This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.

Abstract: An implantable medical device (IMD) includes a memory configured to store a set of therapy parameters for subsensory electrical stimulation of a patient; and therapy delivery circuitry configured to deliver the subsensory electrical stimulation to at least one of a sacral nerve or tibial nerve based on the stored set of therapy parameters to provide immediate therapeutic effect caused by the ongoing delivery of the subsensory electrical stimulation to address incontinence, wherein a stimulation intensity of the subsensory electrical stimulation is less than 80% of a stimulation intensity at a sensory threshold, and wherein the patient does not perceive delivery of the subsensory electrical stimulation and perceives delivery of stimulation at the sensory threshold.

Abstract: The disclosure describes example of subsensory electrical stimulation for providing therapy for incontinence. An implantable medical device (IMD) includes a memory configured to store a set of therapy parameters for subsensory electrical stimulation of a patient. The delivery of the subsensory electrical stimulation results in a therapeutic effect for incontinence therapy at a stimulation intensity that is in range of approximately 50% to 80% of a stimulation intensity at a sensory threshold, and the patient does not perceive delivery of the subsensory electrical stimulation and perceives delivery of stimulation at the sensory threshold. The IMD also includes therapy delivery circuitry configured to deliver the subsensory electrical stimulation based on the stored set of therapy parameters, including cycling the delivery of the subsensory electrical stimulation between an on-cycle and an off-cycle.

Abstract: An example method includes delivering, via an electrical stimulation device, one or more electrical stimulation signals to a patient, sensing one or more stimulation-evoked signals that are evoked by stimulation of nerves or muscles of the patient due to the delivery of the one or more electrical stimulation signals, determining a quality of the one or more stimulation-evoked signals, and outputting, based on the quality of the one or more sensed stimulation-evoked signals being below a quality threshold, one or more instructions to improve the quality of one or more subsequent stimulation-evoked signals.

Abstract: An example method includes delivering one or more electrical stimulation signals to a patient, sensing a composite stimulation-evoked signal comprising a composite of signals generated by one or more signal sources in response to the one or more electrical stimulation signals, and controlling delivery of electrical stimulation therapy to the patient based on the composite stimulation-evoked signal.

Abstract: A sacral lead system including a sacral lead configured to for insertion within a sacral foramen of a patient. The sacral lead supports one or more electrodes which may be configured as one or more stimulation electrodes and/or one or more sensing electrodes. The sacral lead is configured to deliver a stimulation signal to a patient using at least one stimulation electrode and sense an evoked signal produced in response to the stimulation signal using at least one sensing electrode. The sacral lead system may be configured to position the at least one stimulation electrode and/or the at least one sensing electrode within, dorsal, or ventral to the sacral foramen. The sacral lead system may include stimulation circuitry configured to generate the stimulation signal and sensing circuitry configured to receive a signal indicative of the evoked signal.

Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Abstract: Techniques for delivering electrical stimulation therapy comprising a complex variation to at least one electrical stimulation parameter are described. In one example, processing circuitry of an implantable medical device (IMD) identifies a plurality of electrical stimulation parameters for at least one pulse train of electrical stimulation. The processing circuitry defines a complex variation to at least one electrical stimulation parameter of the plurality of electrical stimulation parameters. The processing circuitry modifies the at least one pulse train of electrical stimulation by introducing the complex variation to the electrical stimulation parameter function and controls a stimulation generator of the IMD to generate, as modified, the at least one pulse train of electrical stimulation.

Abstract: In general, techniques, methods, systems, and devices for delivering high frequency neurostimulation to control one or more pelvic disorders are described. In one example, a method includes identifying, by a medical device configured to be at least partially implanted in a patient, an indication to inhibit bladder activity. The medical device generates, in response to identifying the indication, electrical stimulation therapy comprising first electrical stimulation pulses comprising a first frequency greater than or equal to about 500 Hertz and less than or equal to about 5,000 Hertz. Further, the medical device delivers the electrical stimulation therapy to a target nerve selected from a group consisting of: a sacral nerve, a pelvic nerve, a tibial nerve, and a pudendal nerve of the patient.

Abstract: The disclosure describes example of subsensory electrical stimulation for providing therapy for incontinence. An implantable medical device (IMD) includes a memory configured to store a set of therapy parameters for subsensory electrical stimulation of a patient. The delivery of the subsensory electrical stimulation results in a therapeutic effect for incontinence therapy at a stimulation intensity that is in range of approximately 50% to 80% of a stimulation intensity at a sensory threshold, and the patient does not perceive delivery of the subsensory electrical stimulation and perceives delivery of stimulation at the sensory threshold. The IMD also includes therapy delivery circuitry configured to deliver the subsensory electrical stimulation based on the stored set of therapy parameters, including cycling the delivery of the subsensory electrical stimulation between an on-cycle and an off-cycle.

Abstract: This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.

Abstract: This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.

Abstract: A method includes monitoring a sensor signal and classifying a physiological marker of a patient based upon the sensor signal. The method also includes generating a control signal based on the classified physiological marker, the control signal controlling an implantable stimulation device to provide the electrical stimulation at a target site within the patient. The method further includes adapting one or more of a manner in which processor circuitry classifies the physiological markers, generates the control signal, or one or more stimulation parameters of a stimulation program based on the classified physiological markers or patient input so as to automatically adjust one or more of timing or the stimulation parameters of the electrical stimulation.

Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Abstract: This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.

Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Abstract: Techniques for delivering electrical stimulation therapy comprising a complex variation to at least one electrical stimulation parameter are described. In one example, processing circuitry of an implantable medical device (IMD) identifies a plurality of electrical stimulation parameters for at least one pulse train of electrical stimulation. The processing circuitry defines a complex variation to at least one electrical stimulation parameter of the plurality of electrical stimulation parameters. The processing circuitry modifies the at least one pulse train of electrical stimulation by introducing the complex variation to the electrical stimulation parameter function and controls a stimulation generator of the IMD to generate, as modified, the at least one pulse train of electrical stimulation.

Abstract: In general, techniques, methods, systems, and devices for delivering high frequency neurostimulation to control one or more pelvic disorders are described. In one example, a method includes identifying, by a medical device configured to be at least partially implanted in a patient, an indication to inhibit bladder activity. The medical device generates, in response to identifying the indication, electrical stimulation therapy comprising first electrical stimulation pulses comprising a first frequency greater than or equal to about 500 Hertz and less than or equal to about 5,000 Hertz. Further, the medical device delivers the electrical stimulation therapy to a target nerve selected from a group consisting of: a sacral nerve, a pelvic nerve, a tibial nerve, and a pudendal nerve of the patient.

Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.