Abstract: Techniques are disclosed for recharging an Implantable Medical Device (IMD). In one embodiment, a first external coil is positioned on one side of a patient's body, such as on a front side of the torso in proximity to the IMD. A second external coil is positioned on an opposite side of the patient's body, such as on the back of the torso. A recharging device generates a current in each of the coils, inductively coupling the first and the second coils to the secondary recharge coil of the IMD. According to another aspect, each of the two external coils may wrap around a portion of the patient's body, such as the torso or head, and are positioned such that the IMD lies between the coils. According to this aspect, current generated in the coils inductively couples to a second recharge coil that is angled within the patient's body.

Abstract: Some embodiments relate to a method of treating a waste evacuation dysfunction, comprising administering transcutaneous electrical stimulation to at least one lumbar or abdominal region for at least one treatment period per day over a treatment term of at least one week.

Abstract: A medical device is configured to deliver a first stimulation therapy to a patient, and, upon detecting a trigger event, deliver a second stimulation therapy to the patient. In some examples, the first stimulation therapy includes bilateral stimulation in which stimulation is delivered at different times to two lateral sides of the patient and the second stimulation therapy includes substantially simultaneous bilateral stimulation therapy to two lateral sides of the patient. In some examples, the second stimulation therapy may elicit a stronger inhibitory physiological response related to incontinence (e.g., inhibition of bladder contractions) than the first stimulation therapy. The trigger event may include, for example, any one or more of detection of a physiological condition indicative of an increased possibility of an involuntary voiding event or an imminent involuntary voiding event, input from the patient, a predetermined time of day, or expiration of a timer.

Abstract: In general, the disclosure is directed to devices, systems, and techniques for delivering electrical stimulation to a patient with varying pulse frequencies within each burst of pulses. The pulse frequency variation within each burst of pulses may be between approximately 20 Hz and 40 Hz. In some examples, the pulse frequency may be increased, decreased, or polynomially varied within each burst. In other examples, the frequency of intrinsic nerve impulses may be detected and used to deliver pulses with the detected frequency or an inverse of the detected frequency. Electrical stimulation therapy with intra-burst pulse frequency variation may alleviate bladder dysfunction, bowel dysfunction, pain or other disorders.

Abstract: Disclosed is a treatment device for urination disorders, said treatment device being capable of determining whether or not stimulation-applying electrodes are appropriately arranged and whether or not nerves that control urine accumulation and urination are being appropriately stimulated. The disclosed treatment device can therefore provide appropriate treatment for urination disorders.

Abstract: In some examples, a medical device delivers a first electrical stimulation therapy to a patient, and, upon detecting a trigger event, delivers a second electrical stimulation therapy to the patient. In some examples, the first stimulation therapy includes unilateral stimulation or stimulation delivered to both lateral sides of the patient at different times at a stimulation intensity lower than, equal to, or greater than a threshold intensity level for the patient, or bilateral stimulation delivered substantially simultaneously to both lateral sides of the patient, where one lateral side of the patient receives stimulation at an intensity level that is lower than the threshold intensity level and the other lateral side receives stimulation at an intensity level that is greater than or equal to the threshold intensity level. The second stimulation therapy may include substantially simultaneous bilateral stimulation therapy at an intensity level that at or above the threshold intensity level.

Abstract: The invention relates to a rectal stimulator device for the treatment of rectal, fecal and/or urinary incontinence. The device comprises a) an ovoid-shaped stimulator provided with a microcontroller and an electronic circuit for receiving treatment instructions, electrodes for transmitting electrical pulses to the pelvic floor musculature and instructions to the microcontroller, and a battery and b) a stimulator grip member.

Abstract: A medical probe includes an elongate member having a proximal end and a distal end, an ablative element mounted to the distal end of the elongate member, and a cage assembly mounted to the distal end of the elongate member, the cage assembly at least partially covers the ablative element. A method of treating tissue in a body includes inserting an ablative element in the body, placing the ablative element adjacent the tissue, and maintaining a distance between the ablative element and the tissue using a protective catheter element that circumscribes at least a portion of the ablative element.

Abstract: An implantable stimulator(s), small enough to be located near or adjacent to an autonomic nerve(s) innervating urinary and/or gastrointestinal structures, uses a power source/storage device, such as a rechargeable battery. Periodic recharging of such a power source/storage device is accomplished, for example, by inductive coupling with an external appliance. The small stimulator provides a means of stimulating a nerve(s) or other tissue when desired, without the need for external appliances during the stimulation session. When necessary, external appliances are used for the transmission of data to and/or from the stimulator(s) and for the transmission of power, if necessary. In a preferred embodiment, the system is capable of open- and closed-loop operation. In closed-loop operation, at least one implant includes at least one sensor, and the sensed condition is used to adjust stimulation parameters.

Abstract: Systems and methods for determining a number of interruptions in a sleep state of a patient attributable to an urge or need to void during a sleep event include monitoring an activity level of the patient. The urge or need to void may be attributable to fecal or urinary incontinence. The patient activity level may be determined with one or more sensors that detect motion and/or one or more sensors that monitor a physiological parameter of the patient that varies as a function of patient activity. In one embodiment, a clinician selects a therapy parameter set for the patient based on the severity of the patient's incontinence. In another embodiment, the number of interruptions in the sleep state is associated with a therapy parameter set that was implemented during the sleep state in order to evaluate the efficacy of the therapy parameter set.

Abstract: The disclosure describes guided programming for posture state-responsive therapy. The guided programming may include receiving therapy adjustment information that includes therapy adjustments made by a patient to at least one parameter of one or more stimulation therapy programs for one or more patient posture states, generating one or more suggested therapy parameters for one or more of the stimulation therapy programs based on the therapy adjustment information, presenting the suggested therapy parameters to a user.

Abstract: Apparatus is provided, including an implantable mechanical support, shaped to support a portion of a urethra of a patient. One or more electrodes are coupled to the mechanical support, so as to contact tissue of the patient when the mechanical support is implanted in the patient. A control unit drives the electrodes to apply a current to the tissue. A method for treating a patient is also provided, including implanting a mechanical support in a position that supports a urethra of a patient. In response to increased pelvic pressure of the patient, a substance stored in a portion of the mechanical support that is not under the urethra is moved to a portion of the mechanical support that is under the urethra. Other embodiments are also described.

Abstract: Incontinence systems and methods for directing treatment to a target tissue of a patient comprise a guide having a first palpation member and a probe body having a treatment zone and a second palpation member. The guide is configured to be inserted into a urethra of the patient. The first palpation member is positioned in a fixed relationship to an anatomical landmark, such as a bladder neck. The probe body is configured to be inserted into a vagina of the patient. The second palpation member is registered proximal the first palpation member so as to position the treatment zone of the probe adjacent the target tissue of the patient and away from the nerves and/or tissues in the area of the bladder neck and bladder.

Abstract: In general, the disclosure is directed to an implantable neurostimulator and system capable of providing adaptive neurostimulation therapy to alleviate urinary or fecal incontinence. The neurostimulator operates according to a set of stimulation parameters stored in memory. During operation, information is obtained from the patient, the implanted neurostimulator, one or more implanted sensors, or some combination thereof. A processor analyzes the information to automatically generate proposed adjustments to the stimulation parameters applied by the neurostimulator. The adjustments provide an adaptive neurostimulation therapy that supports or enhances therapeutic efficacy based on the information.

Abstract: Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.

Abstract: Transcutaneous electrical and magnetic nerve stimulation devices are disclosed, along with methods of treating lower urinary tract disorders using energy that is delivered noninvasively by the devices. The disorders comprise overactive bladder, urge incontinence, stress, incontinence, urge frequency, non-obstructive urinary retention and interstitial cystitis/painful bladder syndrome. In preferred embodiments of the disclosed methods, a posterior tibial nerve of a patient is stimulated non-invasively. Methods are disclosed for selecting protocol parameters for a nerve stimulation session for treating each individual patient, wherein modules of the bladder of the patient are represented as coupled non-linear oscillators.

Abstract: A desired effect is produced by therapeutically activating tissue at a first site within a patient's body and a corresponding undesired side effect is reduced by blocking activation of tissue or conduction of action potentials at a second site within the patient's body by applying high frequency stimulation and/or direct current pulses at or near the second site. Time-varying DC pulses may be used before or after a high frequency blocking signal. The high frequency stimulation may begin before and continue during the therapeutic activation. The high frequency stimulation may begin with a relatively low amplitude, and the amplitude may be gradually increased. The desired effect may be promotion of micturition or defecation and the undesired side effect may be sphincter contraction.

Abstract: Implantable medical devices to relieve problems associated with incontinence and related pelvic disorders and methods of implanting same are disclosed. Stimulation leads for placement in the pelvic floor have fixation mechanisms for stabilization of the stimulation electrodes to inhibit dislodgement from a selected stimulation site. In certain embodiments, the fixation mechanisms encourage fibrosis about the lead to chronically stabilize the position of the stimulation lead and/or stimulation electrode(s). In certain embodiments, the fixation mechanisms are isolated from body tissue during routing of the stimulation lead through a tissue pathway and then exposed to body tissue to encourage fibrosis.

Abstract: An apparatus for renal neuromodulation includes an expandable support member having a main body portion for engaging a wall of a blood vessel proximate a renal vasculature and at least one electrode connected with the main body portion. The at least one electrode is arranged to selectively deliver electric current to a desired location where modulation of the sympathetic nervous system is effective to alter renal function. The apparatus further includes an insulative material attached to at least a portion of the main body portion for isolating blood flow through the vessel from the electric current delivered by the at least one electrode.

Abstract: An implantable medical device (IMD) is configured to operate as an automatic voiding diary for logging urinary and/or fecal voiding events. The IMD detects urinary and/or fecal voiding events and generates data that identifies detected events as voluntary or involuntary events. In particular, the IMD generates the identification data based on a patient defined action. In one embodiment, the patient defined action is the patient tapping on the skin located above the IMD. The IMD may generate the identification data based on one or more characteristics of the tapping, e.g., the number, frequency, duration, or pattern of taps. The IMD may also generate the identification data based on a lack of input during a specific range of time after a detected voiding event. In some embodiments, the identification data may be used to identify a false positive, i.e., an event that was incorrectly detected by the IMD.

Abstract: The disclosure describes a therapeutic sphincter control system with a fluid tube pressure sensor. The system senses sphincter pressure and sends the information to a stimulator that is capable of stimulation therapy to control sphincter contractility, thus reducing unwanted urinary incontinence. Measuring sphincter pressure is accomplished through the use of a fluid-filled tube placed through the sphincter and attached to a module implanted within the bladder. Pressure within the tube is transduced to generate an electrical signal that is sent wirelessly to an implanted stimulator connected to a lead positioned near pelvic floor nerves. An external device may be used to wirelessly send information to the implanted stimulator and inhibit stimulation in order for the patient to empty the bladder. Pressure information and stimulation information may be recorded and reviewed for continued patient monitoring. In addition, the system may only include the pressure sensor to monitor patient pressure information.

Abstract: A method is provided, including placing first and second electrodes (90) at respective first and second sites of a duodenum (40) of a subject, and activating the electrodes (90) to increase a blood insulin level of the subject. Other embodiments are also described.

Abstract: Embodiments of the invention are generally directed to a method of treating a pelvic condition of a patient through the indirect stimulation of a pelvic neuromuscular structure of the patient. In one embodiment of the method, an electrical stimulation signal is applied to a first neuromuscular structure of the patient. The electrical stimulation signal is communicated through a neural pathway to a second pelvic neuromuscular structure of the patient. The second neuromuscular structure is stimulated in response to the electrical stimulation signal communicated through the neural pathway. The pelvic condition is treated in response to the stimulation of the second pelvic neuromuscular structure.

Abstract: The disclosure describes an external sensor attached to an undergarment worn by a patient that detects voiding information. The sensor stores the voiding information in a voiding log and transmits the voiding log to an external device. The external device includes a user interface that displays the voiding log to the patient for review. The patient may correct any incorrect voiding information that was logged in error or due to a non-voiding event. A user, such as a clinician or the patient, may use the voiding information to diagnose a condition of the patient. In addition, the voiding information of the voiding log may be used by the user to adjust a stimulation therapy or the external device to automatically adjust stimulation therapy. The undergarment may be disposable or washable after patient use.

Abstract: The disclosure describes a therapeutic sphincter control system with a fluid tube pressure sensor. The system senses sphincter pressure and sends the information to a stimulator that is capable of stimulation therapy to control sphincter contractility, thus reducing unwanted urinary incontinence. Measuring sphincter pressure is accomplished through the use of a fluid-filled tube placed through the sphincter and attached to a module implanted within the bladder. Pressure within the tube is transduced to generate an electrical signal that is sent wirelessly to an implanted stimulator connected to a lead positioned near pelvic floor nerves. An external device may be used to wirelessly send information to the implanted stimulator and inhibit stimulation in order for the patient to empty the bladder. Pressure information and stimulation information may be recorded and reviewed for continued patient monitoring. In addition, the system may only include the pressure sensor to monitor patient pressure information.

Abstract: In one embodiment, a method includes implanting an implant entirely under the subject's skin. The implant includes a passive electrical conductor of sufficient length to extend from subcutaneous tissue located below one of a surface cathodic electrode and a surface anodic electrode to the tibial nerve. The surface electrodes are positioned in spaced relationship on the subject's skin, with one of the electrodes positioned over the pick-up end of the electrical conductor such that the portion of the current is transmitted through the conductor to the tibial nerve, and such that the current flows through the tibial nerve and returns to the other of the surface cathodic electrode and the surface anodic electrode. An electrical current is applied between the surface cathodic electrode and the surface anodic electrode to cause the portion of the electrical current to flow through the implant to stimulate the tibial nerve.

Abstract: A therapeutic device for thermally assisted urinary function is presented. The therapeutic pad (14) is composed of an upper thermal element (18) and a lower thermal element (19) having a portal (15), both elements substantially cup-shaped to cover and contact the groin. The therapeutic pad (14) is composed of a material sufficiently capable of storing energy from either an external or internal source. The therapeutic pad (14) communicates stored energy as heat to tissues comprising the groin and regions adjacent thereto. The portal (15) allows for the unimpeded flow of urine from the urinary tract into a receptacle.

Abstract: A system and method for stimulating a nerve, wherein the system includes a first waveform generator adapted to generate a first waveform having a frequency capable of stimulating a predetermined nerve of the mammal, a second waveform generator adapted to generate a carrier waveform having a frequency capable of passing through tissue of the mammal, a modulation device electrically coupled to the first and second waveform generators and adapted to modulate the first and carrier waveforms to create a modulated waveform, and an electrode electrically coupled to the modulation device and positioned substantially adjacent to skin of the mammal, and adapted to apply the modulated waveform thereto.

Abstract: The invention provides a perineal rehabilitation device comprising an applicator that is either an endocavity applicator (100) or an annular applicator (100?), locally supporting a charging electrode (104, 105) and at least one stimulation electrode (101, 102) respectively on its periphery or on its inside face, and including at least one energy storage unit that is rechargeable via the charging applicator (104, 105), the applicator (100, 100?) including at least one microprocessor for executing an electrical stimulation program, the device being characterized in that the applicator (100, 100?) is controlled by a control module (200) in the form of a remote control connected to the applicator (100, 100?) by a wireless connection and including a user interface for enabling the user to input operating data for the applicator (100, 100?) and a control unit for controlling the applicator (100, 100?) by sending control signals thereto, the applicator (100, 100?) being suitable for receiving control signals for mod

Abstract: A method for altering operation of a nerve related to a given body condition includes the steps of identifying at least one nerve root of a nerve related to the given body condition; laparoscopically implanting at least one electrode on the nerve root; and operating the electrode to electrostimulate the nerve root and alter operation of the nerve.

Abstract: A body-worn device for a fast healing of incontinence by building up the necessary durable behavioral conditioning, which provides the brain with the necessary proper control over the respective sphincters. The device is based on two different nerve mechanisms: a first electrical pulse stops the release of bodily wastes by a simple local reflex, arousing simultaneously the brain and preparing it to respond to a second, behavioral conditioning causing electric pulse, which follows within two seconds (i.e. still during the phasic period of the cortical learning process), strong enough to cause an unpleasant sensation, which the brain connects with the just begun incontinent release of bodily waste and acquires after only a few applications as a durable adversive behavioral conditioning. This shortens the healing period from many months to only a few days. The device is easily adjustable to the individual sensitivity of the involuntarily wetting or soiling person.

Abstract: The disclosure describes a sensing device that is implantable to sense bladder conditions, as well as a neurostimulation system and method that make use of such a sensor for alleviation of urinary incontinence. The sensing device is implantable outside the bladder, but includes a lead that penetrates the bladder wall to deploy a sensor within the bladder. Using the sensor on the lead, the sensing device outside the bladder is able to detect a condition within the interior of the bladder. In this sense, the sensing device provides transmembrane sensing of internal bladder conditions. The condition may be indicative of bladder filling or bladder contraction, and may be used to control electrical stimulation applied to the patient to alleviate urinary incontinence.

Abstract: A system and method for stimulating a nerve, wherein the system includes a first waveform generator adapted to generate a first waveform having a frequency capable of stimulating a predetermined nerve of the mammal, a second waveform generator adapted to generate a carrier waveform having a frequency capable of passing through tissue of the mammal, a modulation device electrically coupled to the first and second waveform generators and adapted to modulate the first and carrier waveforms to create a modulated waveform, and an electrode electrically coupled to the modulation device and positioned substantially adjacent to skin of the mammal, and adapted to apply the modulated waveform thereto.

Abstract: Various embodiments of an implant system are provided. The implant, such as a mesh implant, can include a support structure, e.g., mesh sling or implant, one or more stimulation elements (e.g., leads), and an energizing element. Leads or electrodes can be positioned in desired stimulation zones of the implant. As such, the implant can include multiple electrically isolated mesh electrode pads or regions.

Abstract: Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy. In some examples, objective incontinence information is generated based upon the trigger events. The system and/or user may then use this objective incontinence information to adjust therapy or select new therapy programs for improved efficacy.

Abstract: A sensor based gastric stimulator system and method for gastric stimulation of a patient employing an implantable gastric stimulator, which includes an information processor, an electrical stimulator circuit, and telemetry circuitry. The implantable stimulator senses intrinsic, gastric electrical activity (slow waves and/or peristaltic waves) and delivers electrical stimulation to intentionally disrupt or disorganize that activity. The stimulation is triggered by (tracks) normal gastric electrical activity and can be delivered with a spatial offset to anticipate the propagating gastric electrical activity or may be delayed temporally to anticipate the next propagating slow or peristaltic wave. The stimulator may be programmed to disrupt/disorganize all or a percentage of the intrinsic, normal gastric electrical activity. The programmer (via radio frequency data link) may non-invasively program stimulation parameters and intervals.

Abstract: The disclosure describes an optical fiber pressure sensor to measure sphincter pressure which may be incorporated into a therapeutic sphincter control system. The system senses sphincter pressure and sends the information to a stimulator that is capable of stimulation therapy to control sphincter contractility, thus reducing unwanted urinary incontinence. Measuring sphincter pressure is accomplished through the use of an optical fiber connected to flexible tube section placed through the sphincter, where properties of the emitted light are changed proportional to the pressure on the tube section. The light is returned to a light detector to measure light properties and create an electrical signal representative of the pressure on the tube section. The signal may then be sent by wireless telemetry to an implanted stimulator or external programmer.

Abstract: The disclosure describes a sensing device that is implantable to sense bladder conditions, as well as a neurostimulation system and method that make use of such a sensor for alleviation of urinary incontinence. The sensing device is implantable outside the bladder, but includes a lead that penetrates the bladder wall to deployed a sensor within the bladder. Using the sensor on the lead, the sensing device outside the bladder is able to detect a condition within the interior of the bladder. In this sense, the sensing device provides transmembrane sensing of internal bladder conditions. The condition may be indicative of bladder filling or bladder contraction, and may be used to control electrical stimulation applied to the patient to alleviate urinary incontinence.

Abstract: A method of using a stimulation device to emit a medium to an appendicular region and/or rectal region of a user for treatment of a gastrointestinal disorder is described. The method includes placing the stimulation device into the appendicular region and/or rectal region, and delivering the medium, wherein the medium stimulates at least a portion of the enteric nervous system. Additionally, apparatus and delivery devices are disclosed.

Abstract: An apparatus for controlling a flow of fluid and/or other bodily matter in a lumen formed by a tissue wall of a patient's organ comprises an implantable constriction device for gently constricting (i.e. without substantially hampering the blood circulation in the tissue wall) at least one portion of the tissue wall to influence the flow in the lumen, and a stimulation device for stimulating the wall portion of the tissue wall. A control device controls the stimulation device to stimulate the wall portion, as the constriction device constricts the wall portion, to cause contraction of the wall portion constricted by the constriction device to further influence the flow in the lumen. The apparatus can be used for restricting or stopping the flow in the lumen, or for actively moving the fluid in the lumen, with a low risk of injuring the organ.

Abstract: It is an object of the present invention to provide a method and apparatus for enhanced bladder voidance which would have the advantages of a rhizotomy yet be temporary and reversible by combining low and high-frequency sacral nerve stimulation. Applicants propose a new sacral neurostimulation strategy based on a combination of nerve conduction blockade using high frequency signals and nerve stimulation using low-frequency signals. The method and apparatus enhances micturition in paraplegics by sacral neurostimulation involving a combination of a low-frequency electrical stimulation applied to one or more sacral nerves to induce bladder contraction and a high frequency electrical stimulation applied to at least one sacral nerve to cause nerve conduction blockade that prevents urethral sphincter dyssynergic contraction.

Abstract: There is provided a method for controlling a flow of fluid and/or other bodily matter in a lumen formed by a tissue wall of a patient's organ. The method comprises gently constricting (i.e., without substantially hampering the blood circulation in the tissue wall) at least one portion of the tissue wall to influence the flow in the lumen, and stimulating the constricted wall portion to cause contraction of the wall portion to further influence the flow in the lumen. The method can be used for restricting or stopping the flow in the lumen, or for actively moving the fluid in the lumen, with a low risk of injuring the organ. Such an organ may be the esophagus, stomach, intestines, urine bladder, urethra, ureter, renal pelvis, aorta, corpus cavernosum, exit veins of erectile tissue, uterine tube, vas deferens or bile duct, or a blood vessel.

Abstract: A treatment method is provided, including identifying a subject as one who is selected to undergo an interventional medical procedure, and, in response to the identifying, reducing a likelihood of a potential adverse effect of the procedure by applying an electrical current to a parasympathetic site of the subject selected from the group consisting of: a vagus nerve of the subject, an epicardial fat pad of the subject, a pulmonary vein of the subject, a carotid artery of the subject, a carotid sinus of the subject, a coronary sinus of the subject, a vena cava vein of the subject, a jugular vein of the subject, a right ventricle of the subject, a parasympathetic ganglion of the subject, and a parasympathetic nerve of the subject.

Abstract: Methods and apparatus are provided for pulsed electric field neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly.

Abstract: The disclosure describes an absorbent pad worn by a patient that measures one or more urinary voiding parameters. One or more sensors that measure voiding parameters are integrally formed with the pad, e.g., interwoven with the absorbent pad material or positioned to form one or more sensor layers between layers of absorbent material. The sensors store measured parameters as information in a memory, e.g., as a log, locally or in a separate device. In some embodiments, the pad includes an electrical stimulator that provides stimulation therapy for urinary incontinence based on measured parameters.

Abstract: Diet evaluation gastric apparatus (18) is provided, which detects when a patient (10) swallows, and detects the type and amount of matter ingested. The apparatus includes electrodes (74, 100) adapted to be coupled to the fundus and antrum of the patient and to measure electrical and mechanical activity therein, and a control unit (90) to analyze such electrical and mechanical activity and optionally apply electrical energy to modify the activity of tissue of the patient.

Abstract: A sphincteric control system for controlling the function of a bodily organ, such as the bladder. The system includes a first implanted sphincter disposed about a portion of the bodily organ, a second implanted sphincter disposed about a portion of the bodily organ, and a stimulator unit that is adapted to apply electrical stimulation to each of the first and second implanted sphincters. One of the first or second implanted sphincters is made from a smooth muscle and the other of the first or second implanted sphincters is made from a striated muscle.

Abstract: Systems and Methods treat bladder dysfunctions using neuromodulation stimulation. Bladder emptying through stimulation of urethral afferents, and continence through stimulation of the dorsal genital nerve, is provided with one or more implanted pulse generators and one or more leads. A simple surgical procedure preserves all existing functions. A stimulating catheter is provided to be used as a clinical screening tool. The stimulating catheter is used to measure bladder pressures and stimulate the urethra at the same time.

Abstract: The disclosure describes a sensing device that is implantable to sense bladder conditions, as well as a neurostimulation system and method that make use of such a sensor for alleviation of urinary incontinence. The sensing device is implantable outside the bladder, but includes a lead that penetrates the bladder wall to deployed a sensor within the bladder. Using the sensor on the lead, the sensing device outside the bladder is able to detect a condition within the interior of the bladder. In this sense, the sensing device provides transmembrane sensing of internal bladder conditions. The condition may be indicative of bladder filling or bladder contraction, and may be used to control electrical stimulation applied to the patient to alleviate urinary incontinence.

Abstract: Techniques for remotely titrating a therapy delivered using an implantable medical device system are disclosed. An implantable medical device delivers therapy according to a first program. The system collects patient data relating to at least one of an efficacy of, or side effects resulting from, the delivered therapy, and transmits the patient data to a remote network device. A clinician may then analyze the patient data and determine if changes to the therapy are warranted. The clinician may then transmit a programming change, e.g., a modification to the first program or a new, second program, to the implantable medical device system, and the implantable medical device may deliver therapy according to the changed programming. The process of receiving patient data and modifying the therapy programming may be repeated multiple times until the therapy is adequately titrated, e.g., until the patient data indicates adequate efficacy and/or acceptable side effects.