System and Method of Bladder and Sphincter Control

Abstract

A method and system for bladder control are disclosed. In embodiments, a method for bladder control is provided that comprises coupling an electrode to an afferent nerve that is related to the bladder. Applying a plurality of pulse burst stimulations via the electrode causes voiding of urine from the bladder. In embodiments, the plurality of pulse burst stimulations to the afferent nerve reduces external urethral sphincter (EUS) contractions and evokes bladder contractions to expel urine from the subject. In embodiments, the plurality of pulse burst stimulations to the afferent nerve evokes bladder contractions alone to expel urine from the subject. In embodiments, a system for bladder control is provided that comprises an electrode for applying a pulse burst stimulus to an afferent nerve or dermatome to reduce reflex contractions and a signal generator for generating the pulse burst stimulus.

1 . A method for bladder control, comprising:
 electrically coupling an electrode to an afferent nerve that is anatomically related to the bladder;   stimulating said afferent nerve via said electrode with a plurality of pulse burst electrical stimulations, wherein said pulse burst electrical stimulations have an inter-burst frequency of about 0.25 to about 50 Hz, wherein each of said pulse burst electrical stimulations comprises between 2 and 20 individual pulses, wherein each of said pulse burst electrical stimulations has a width of about 10 to about 300 microseconds, and wherein each of said individual pulses has an intra-burst pulse frequency of about 10 Hz to about 250 Hz; and   voiding urine from the bladder via the urethra through an external urethral sphincter.   
   
   
       2 . The method of  claim 1 , further comprising:
 modulating one of said pulse burst electrical stimulations, said modulating selected from the group consisting of modulating an inter-burst frequency, modulating an inter-burst amplitude, modulating an intra-burst pulse frequency, modulating an intra-burst pulse amplitude, and modulating to create a patterned pulse burst electrical stimulation.   
   
   
       3 . The method of  claim 1 , wherein said stimulating said afferent nerve reduces contractions of said external urethral sphincter and further comprising:
 stimulating a second nerve anatomically related to the bladder with a second pulse burst electrical stimulation synchronized with said plurality of pulse burst electrical stimulations to induce a contraction of the bladder.   
   
   
       4 . The method of  claim 3 , further comprising:
 wherein said second pulse burst electrical stimulation occurs during a portion of one of said plurality of pulse burst electrical stimulations.   
   
   
       5 . The method of  claim 3 , wherein said second nerve is selected from the group consisting of an afferent nerve for exciting a reflex contraction of the bladder, an efferent nerve, an intradural nerve, a sacral ventral root, an extradural nerve, a motor nerve, a pelvic nerve, a sacral foraminal nerve, and a dermatome. 
   
   
       6 . The method of  claim 1 , further comprising:
 initiating a contraction of the bladder.   
   
   
       7 . The method of  claim 1 , wherein said afferent nerve is selected from the group consisting of an intradural nerve, a sacral dorsal root, an extradural nerve, a sensory nerve, a pelvic nerve, a sacral foraminal nerve, a pudendal nerve, and a dermatome. 
   
   
       8 . The method of  claim 1 , wherein said stimulating is performed subcutaneously using an electrode selected from the group consisting of a cuff electrode, a subcutaneous electrode, a spiral electrode, a helical electrode, and a needle electrode. 
   
   
       9 . The method of  claim 1 , wherein said stimulating is performed to the dermis using an electrode selected from the group consisting of a surface electrode, and a subcutaneous needle electrode. 
   
   
       10 . A system for bladder control, comprising:
 an electrode for applying a pulse burst electrical stimulus to an afferent nerve to inhibit reflex contractions; and   a signal generator for generating said pulse burst electrical stimulus to be applied by said electrode, said pulse burst electrical stimulus comprising between 2 and about 20 individual pulses, said pulse burst electrical stimulus having a width of about 50 to about 300 microseconds, and each of said individual pulses having an intra-burst pulse frequency of about 10 Hz to about 250 Hz.   
   
   
       11 . The system of  claim 10 , wherein said electrode is selected from the group consisting of a cuff electrode, a subcutaneous electrode, a spiral electrode, a needle probe, a dermal surface electrode, and a surface mounted needle. 
   
   
       12 . The system of  claim 10 , wherein said afferent nerve is selected from the group consisting of an intradural nerve, a sacral dorsal root, an extradural nerve, a sensory nerve, a pelvic nerve, a sacral foraminal nerve, a pudendal nerve, and a dermatome. 
   
   
       13 . The system of  claim 10 , wherein said pulse burst electrical stimulus reduces contractions of an external urethral sphincter, and wherein a contraction of the bladder is initiated using a mechanical technique selected from the group consisting of distention, pressing on a skin region near the bladder, and tapping on a skin region near the bladder, and wherein said contraction of the bladder induces micturition through said external urethral sphincter. 
   
   
       14 . The system of  claim 10 , wherein said signal generator is adapted to generate a plurality of pulse burst electrical stimuli having an inter-burst frequency of about 0.25 to about 50 Hz. 
   
   
       15 . The system of  claim 14 , wherein said pulse burst electrical stimulus is modulated using a modulation selected from the group consisting of an inter-burst frequency modulation, an inter-burst amplitude modulation, an intra-burst pulse frequency modulation, an intra-burst pulse amplitude modulation, and a pattern modulation. 
   
   
       16 . The system of  claim 10 , wherein said pulse burst electrical stimulus reduces contractions of an external urethral sphincter, and further comprising:
 a second electrode for applying an electrical stimulus, said electrical stimulus synchronized with said plurality of pulse burst electrical stimuli, wherein said electrical stimulus occurs during a portion of said pulse burst electrical stimuli, and wherein said electrical stimulus induces contractions of the bladder.   
   
   
       17 . The system of  claim 16 , wherein said electrical stimulus is a second pulse burst stimulus comprising between 2 and 20 individual pulses, said pulse burst electrical stimulus having a width of about 50 to 300 microseconds and an inter-burst frequency of about 0.25 to about 50 Hz, and each of said individual pulses having an intra-burst pulse frequency of about 10 Hz to about 250 Hz; and wherein said second pulse burst stimulus is modulated using a modulation selected from the group consisting of a consistent modulation, an inter-burst frequency modulation, an inter-burst amplitude modulation, an intra-burst pulse frequency modulation, an intra-burst pulse amplitude modulation, and a pattern modulation. 
   
   
       18 . The system of  claim 16 , wherein said electrical stimulus is applied to an afferent nerve to excite reflex contractions of the bladder, and wherein said afferent nerve is selected from the group consisting of an intradural nerve, a sacral ventral root, an extradural nerve, a motor nerve, a pelvic nerve, a sacral foraminal nerve, and a dermatome. 
   
   
       19 . The system of  claim 16 , wherein said electrical stimulus is applied to an efferent nerve selected from the group consisting of an intradural nerve, a sacral ventral root, an extradural nerve, a motor nerve, a pelvic nerve, a sacral foraminal nerve. 
   
   
       20 . A method for bladder control, the method comprising:
 applying a plurality of pulse burst electrical signals to a sensory nerve that causes the reduction or elimination of urethral sphincter (EUS) contractions, the sensory nerve being at least one of an intradural nerve, an extradural nerve, a pudendal nerve, pelvic nerves, a foraminal nerve and a dermatome; and   applying a stimulus to evoke bladder contractions to expel urine from the subject, the stimulus being at least one of a non-quasitrapezoidal pulse burst electrical stimulus.