In some examples, a method including determining a chronaxie of evoked threshold motor responses from electrical stimulation delivered to a sacral nerve of a patient; and delivering, based on the determined chronaxie, electrical stimulation therapy, configured to treat a patient condition, to the sacral nerve having a pulse width at or near the identified chronaxie, wherein the delivered electrical stimulation is configured to inhibit contraction of at least one a bladder or bowel of the patient.

Embodiments of the invention provide apparatus, systems and methods for facilitating introduction of a urinary drainage catheter (UDC) into the urinary tract (UT). One embodiment provides a UDC including electrodes for delivering high frequency current to a patient's pudendal nerves to relax the urinary sphincter (US) before passing the UDC therethrough so as reduce the resistance force on the UDC and discomfort to the patient. The electrodes can comprise at least one pair of bipolar electrodes and may be flexible so as to bend and flex within the urethra. The UDC includes one or more lumens including a drainage lumen and an inflation lumen for inflating an anchoring device on the UDC. The UDC can include a pressure sensor to assess relaxation of the US. The UDC may include a second set of electrodes and irrigation lumen for relaxing the US and flushing the urethra with the UDC in place.

In some examples, a technique for delivering electrical stimulation therapy to a patient includes determining, by processing circuitry, one or more cycle settings associated with delivery of the electrical stimulation therapy, determining, by the processing circuitry, a cycle time period associated with each cycle setting, and delivering, by a medical device, electrical stimulation therapy based on the determined cycle settings and the determined cycle time periods. Each cycle setting may define an on-cycle, during which electrical stimulation is delivered, and an off-cycle, during which electrical stimulation is not delivered. The technique further may include delivering electrical stimulation to the patient to provide one or more reminders to the patient, such as a reminder to void or a reminder of the existence of electrical stimulation.

A device for stimulating nerves adjacent the vagina includes a nerve stimulating element coupled to a main body. The nerve stimulating element is positioned and designed to stimulate the vesical, Frankenhauser's and/or inferior hypogastric plexuses. The device may reside in the vaginal fornices. An implant is also provided which has a nerve stimulating element in contact with a uterosacral ligament. The device positioned in the vagina may be used to charge a power source for an implant which may be a capacitor.

Embodiments of the invention provide apparatus and methods for testing the efficacy of nerve stimulation therapy to treat patients who have urinary dysfunction prior to the implantation of an apparatus to treat the dysfunction. The apparatus and methods provide means to selectively stimulate the pudendal nerve with high and low frequency current to produce a physiologic response involved in the urination process (e.g., relaxation of the urinary sphincter and contraction of the bladder) and then measure information relating to the response. Particular embodiments involve the introduction of a urethral catheter configured to both fill the bladder and test the ability to control bladder voiding by applying stimulation current to the pudendal nerve and then measure the response information such as bladder pressure, urinary sphincter pressure and urinary flow rate. The catheter can include at least two electrodes and separate pressure sensors positioned for measuring the urinary sphincter and bladder pressure.

An implantable electrode assembly configured to deliver electrical stimulation signals to tissue of a patient includes an implantable mesh comprising a plurality of electrically conductive wires. A plurality of electrodes are fastened to the electrically conductive wires. The electrodes include a stimulation surface and an electrically conductive path between the stimulation surface and the wire, to which the electrode is attached. In one embodiment, the plurality of electrodes each comprise first and second members that are fastened together around one of the electrically conductive wires.

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, electrical stimulation is delivered to a patient such that selective termination of the stimulation causes a therapeutic effect in the patient after termination of the electrical stimulation to the patient. The electrical stimulation may be insufficient to produce a desired therapeutic effect in the patient during stimulation, but sufficient to induce a post-stimulation desired therapeutic effect following termination of the stimulation. In some examples, the electrical stimulation may be sub-threshold electrical stimulation. In some examples, the desired therapeutic effect may alleviate bladder dysfunction, bowel dysfunction, or other disorders. The stimulation may be selectively terminated in response to one or more therapy trigger events to induce the post-stimulation therapeutic effect.

This present disclosure provides devices, systems, and methods for the treatment of conditions pertaining to bladder control. In particular, the present disclosure provides devices, systems, and methods directed to the application of electrical stimulation to the proximal urethra and associated nervous tissue to elicit voiding contractions that normalize bladder function.

Apparatus for facilitating ablation of nerve tissue of a subject is provided, comprising (1) an ablation unit, configured to be percutaneously advanced to a site adjacent to a first portion of the nerve tissue; (2) at least one electrode unit, coupled to the ablation unit, and configured to be percutaneously advanced to a site adjacent to a second portion of the nerve tissue, and to initiate unidirectional action potentials in the nerve tissue, such that the unidirectional action potentials propagate toward the first portion of the nerve tissue; and (3) a control unit, configured: (a) to drive the ablation unit to ablate, at least in part, the first portion of the nerve tissue of the subject, and (b) to drive the at least one electrode unit to initiate the unidirectional action potentials by applying an excitatory current to the second portion of the nerve tissue.