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.

A bladder fullness monitoring system includes a controller and an active optical sensor that is affixed to a patient's bladder. The sensor emits light onto the bladder and further detects light reflected from the bladder, in order to generate an output signal that indicates an amount of emitted light was reflected back to the detector. The controller is coupled to the optical sensor to receive and interpret the output signals, e.g., to determine when the bladder is full. The controller may be operatively coupled to a urinary control apparatus which uses the output signals to trigger urination in patients who have lost the ability to voluntarily urinate. Embodiments are particularly useful for monitoring bladder fullness in patients who have lost bladder sensation and/or the ability to voluntary urinate and rely on a urinary control apparatus in order to urinate.

A bladder fullness monitoring system includes a controller and an active optical sensor that is affixed to a patient's bladder. The sensor emits light onto the bladder and further detects light reflected from the bladder, in order to generate an output signal that indicates an amount of emitted light was reflected back to the detector. The controller is coupled to the optical sensor to receive and interpret the output signals, e.g., to determine when the bladder is full. The controller may be operatively coupled to a urinary control apparatus which uses the output signals to trigger urination in patients who have lost the ability to voluntarily urinate. Embodiments are particularly useful for monitoring bladder fullness in patients who have lost bladder sensation and/or the ability to voluntary urinate and rely on a urinary control apparatus in order to urinate.

A system and method is disclosed for measuring muscle reflexes (e.g., a bulbocavernosus reflex) as a tool for identifying/diagnosing dysfunctions (e.g., spinal cord abnormalities, bladder voiding dysfunction, and sexual organ dysfunction) non-invasively by using mechanical stimulation. The system and method includes a probe having a predetermined patient contacting portion, wherein when the contacting portion is moved into contact with a particular area of the patient (e.g., the patient's genitals), the contact induces a muscle reflex. The probe detects the pressure resulting from the contacting portion being abruptly and forcibly brought into contact with the particular area. Such detection is used to electronically initiate capture of electrical responses from a plurality of electrodes placed on the patient's skin in proximity to the particular area. Such electrical responses are processed to determine characteristics of the patient's reflexes of one or more muscles adjacent to the electrodes.

A system and method is disclosed for measuring muscle reflexes (e.g., a bulbocavernosus reflex) as a tool for identifying/diagnosing dysfunctions (e.g., spinal cord abnormalities, bladder voiding dysfunction, and sexual organ dysfunction) non-invasively by using mechanical stimulation. The system and method includes a probe having a predetermined patient contacting portion, wherein when the contacting portion is moved into contact with a particular area of the patient (e.g., the patient's genitals), the contact induces a muscle reflex. The probe detects the pressure resulting from the contacting portion being abruptly and forcibly brought into contact with the particular area. Such detection is used to electronically initiate capture of electrical responses from a plurality of electrodes placed on the patient's skin in proximity to the particular area. Such electrical responses are processed to determine characteristics of the patient's reflexes of one or more muscles adjacent to the electrodes.

A urodynamic investigation apparatus for receipt of urine from a bladder is provided. The apparatus is characterized by a tubular element, first and second fittings, and a sleeve element, for select passage of urine there through, within the tubular element. The tubular element is characterized by opposing first and second end portions, and a port. The fittings are adapted to be received by the opposing end portions of the tubular element so as to delimit an apparatus chamber. The sleeve element, suspended between the fittings within the chamber, has collapsed and open configurations. The collapsed configuration is indicative of a no urine flow condition, and the open configuration indicative of a urine flow condition, with the sleeve element urine flow condition being a function of pressure applied to the chamber via the port of the tubular element.

A computer-implemented method includes providing, by at least one computer processor, a plurality of signal channels, wherein the plurality of signal channels includes a plurality of electrical uterine monitoring signal channels and a plurality of acoustic uterine monitoring signal channels; determining, by the at least one computer processor, a plurality of channel weights, wherein each of the channel weights corresponds to a particular one of the signal channels; and generating, by the at least one computer processor, a combined uterine monitoring signal channel by calculating a weighted average of the signal channels based on the channel weight for each of the signal channels.

A computer-implemented method includes providing, by at least one computer processor, a plurality of signal channels, wherein the plurality of signal channels includes a plurality of electrical uterine monitoring signal channels and a plurality of acoustic uterine monitoring signal channels; determining, by the at least one computer processor, a plurality of channel weights, wherein each of the channel weights corresponds to a particular one of the signal channels; and generating, by the at least one computer processor, a combined uterine monitoring signal channel by calculating a weighted average of the signal channels based on the channel weight for each of the signal channels.

Example systems for positioning an implantable electrode may include a stimulation circuitry, a sensing circuitry, and processing circuitry. The stimulation circuitry may generate electrical stimulation deliverable to a patient. The sensing circuitry may sense electromyographic (EMG) responses. The processing circuitry may control the stimulation circuitry to deliver the electrical stimulation at a plurality of different stimulation metric levels at each of a plurality of different positions. The processing circuitry may sense, via the sensing circuitry, electromyographic (EMG) responses to the electrical stimulation. The processing circuitry may score one or more of the different positions for chronic implantation of at least one implantable electrode. The scoring may be based on a stimulation metric level greater than a predetermined metric threshold sufficient to evoke at least some of the sensed EMG responses, and a level of the at least some of the sensed EMG responses.

Example systems for positioning an implantable electrode may include a stimulation circuitry, a sensing circuitry, and processing circuitry. The stimulation circuitry may generate electrical stimulation deliverable to a patient. The sensing circuitry may sense electromyographic (EMG) responses. The processing circuitry may control the stimulation circuitry to deliver the electrical stimulation at a plurality of different stimulation metric levels at each of a plurality of different positions. The processing circuitry may sense, via the sensing circuitry, electromyographic (EMG) responses to the electrical stimulation. The processing circuitry may score one or more of the different positions for chronic implantation of at least one implantable electrode. The scoring may be based on a stimulation metric level greater than a predetermined metric threshold sufficient to evoke at least some of the sensed EMG responses, and a level of the at least some of the sensed EMG responses.