A method to treat a patient having a pelvic floor dysfunction by establishing a neurostimulator having a processor and a signal generator to generate a stimulation signal. The processor is set to one or more parameters effective in the treating of the patient's pelvic dysfunction when the stimulation signal is applied to a saphenous nerve of the patient. The neurostimulator is configured to provide the stimulation signal to a stimulator in accordance with a stimulation protocol. At least one stimulator is positioned next to a portion of the saphenous nerve of at least one lower limb of a patient. The processor is operationally activated to provide the stimulation signal to the stimulator for treatment of the patient.

In some examples, a medical device is configured to deliver high dose electrical stimulation therapy to a patient by at least generating and delivering an electrical stimulation signal having a relatively high duty cycle, and a stimulation intensity less than a perception or paresthesia threshold intensity level for the patient. The pulses may each have a relatively low amplitude, but due at least in part to a relatively high number of pulses per unit of time, the electrical stimulation signal may be high enough to elicit a therapeutic response from the patient. In some examples, the plurality of pulses may have a duty cycle in a range of about 5% to about 50%. Following the generation and delivery of the plurality of pulses, one or more recharge pulses for the plurality of pulses may be delivered.

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may be configured to deliver electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of therapy pulses at a predetermined pulse frequency over a period of time and deliver, over the period of time, a plurality of control pulses interleaved with at least some therapy pulses of the plurality of therapy pulses. The system may also be configured to sense, after one or more control pulses and prior to an immediately subsequent therapy pulse of the plurality of therapy pulses, a respective evoked compound action potential (ECAP), adjust, based on at least one respective ECAP, one or more parameter values that at least partially defines the plurality of therapy pulses, and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

The present invention relates to method for implanting a medical device for controlling a flow of fluid in a lumen formed by a tissue wall of a patient's urethra. The method is performed by: cutting the skin of the patient, inserting a dissecting tool and dissecting an area of at least one portion of the tissue wall of the urethra, placing an adjustable constriction device in the dissected area in operative engagement with the urethra, placing an operation device configured to operate the adjustable constriction device to control the flow of urine in the urethra in the patient's body, placing a sensor configured to sense a temperature of the medical device in the patient's body, and placing a control unit in the patient's body configured to control the operation device based on information from the sensor.

There is disclosed an apparatus for treating a sexual dysfunctional female patient, comprising a stimulation device adapted to stimulate an erectile blood passageway to increase the amount of blood in the female erectile tissue and thereby obtaining engorgement with blood of the female erectile tissue by affecting said erectile blood flow passageway. Moreover there is disclosed a system and an operation method for treating a sexual dysfunctional female patient.

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.

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.

Devices and methods for providing neurostimulation to a patient, particularly in trial systems assessing suitability of a permanently implanted neurostimulation, are provided herein. In one aspect, a trial neurostimulation lead includes a coiled conductor coupled to a proximal contact connector having a retention flange that withstands tensile force from tension in the lead so as to maintain the electrical connection during a trial period. In another aspect, a trial neurostimulation system includes a lead extension that includes a regression stopper between the implanted distal connector and proximal lead disposed outside the body to prevent regression of the lead through a secondary incision, thereby preventing infection and facilitating explant of the system. Methods of assembling and utilizing such leads and systems are detailed herein.

Systems, devices, and techniques for adjusting electrical stimulation based on a posture state of a patient are described. For example, processing circuitry is configured to control delivery of a first informed stimulation pulse defined by at least a first value of an informed stimulation parameter, control delivery of a control stimulation pulse to a patient, the control stimulation pulse defined by at least a first value of a control stimulation parameter, determine a characteristic value of the ECAP signal elicited from the control stimulation pulse, receive, from a sensor, a posture state signal representing a posture state of the patient, and adjust, based on the characteristic value of the ECAP signal and the posture state signal, the first value of the informed stimulation parameter to a second value of the informed stimulation parameter.

Systems, devices, and techniques for adjusting electrical stimulation based on a posture state of a patient are described. For example, a system may include sensing circuitry configured to sense an ECAP signal and processing circuitry configured to control delivery of the electrical stimulation to a patient according to a first value of a stimulation parameter and determine a characteristic value of the ECAP signal. The processing circuitry may also be configured to receive, from a sensor, a posture state signal representing a posture state of the patient, determine, based on the posture state signal, a gain value for the stimulation parameter, adjust, based on the characteristic value of the ECAP signal and the gain value, the first value of the stimulation parameter to a second value of the stimulation parameter, and control delivery of the electrical stimulation according to the second value of the stimulation parameter.