公开(公告)号：US06735474B1

公开(公告)日：2004-05-11

申请号：US09642979

申请日：2000-08-18

申请人： Gerald E. Loeb ,  Francis J. R. Richmond ,  Carla M. Mann ,  Michael A. Faltys ,  Todd K. Whitehurst ,  James P. McGivern

发明人： Gerald E. Loeb ,  Francis J. R. Richmond ,  Carla M. Mann ,  Michael A. Faltys ,  Todd K. Whitehurst ,  James P. McGivern

IPC分类号： A61N136

CPC分类号： A61N1/36007 ,  A61N1/36071 ,  A61N1/37205

摘要： A method and system for treatment of incontinence and/or pelvic pain includes the injection or laparoscopic implantation of one or more battery- or radio frequency-powered microstimulators (10) beneath the skin of the perineum and/or adjacent the tibial nerve. The devices are programmed using radio-frequency control via an external controller (20, 30)) that can be used by a physician to produce patterns of output stimulation pulses judged to be efficacious by appropriate clinical testing to diminish symptoms. The stimulation program is retained in the microstimulator device (10) or external controller (20) and is transmitted when commanded to start and stop by a signal from the patient or caregiver. The system and method reduce the incidence of unintentional episodes of bladder emptying by stimulating nerve pathways (8) that diminish involuntary bladder contractions, improve closure of the bladder outlet, and/or improve the long-term health of the urinary system by increasing bladder capacity and period between emptying. The incidence of fecal incontinence is similarly reduced or eliminated. Furthermore, the system and method reduce or eliminate the incidence of pelvic pain by chronically stimulating nerve pathways that derive from the sacral roots using a miniature implantable neurostimulator that can be implanted with a minimal surgical procedure. Moreover, the system and method allow a patient to be taught to receive one or more patterns of neural stimulation that can be prescribed by a physician and administered without continuous oversight by a clinical practitioner.

摘要翻译： 用于治疗失禁和/或骨盆疼痛的方法和系统包括在会阴皮肤和/或邻近胫神经之下的一个或多个电池或射频激励微刺激器（10）的注射或腹腔镜植入。 所述装置通过外部控制器（20,30）使用射频控制进行编程，所述外部控制器（20,30））可由医生用来产生通过适当的临床测试判断为有效的输出刺激脉冲的模式以减少症状。 刺激程序被保留在微型刺激器装置（10）或外部控制器（20）中，并且在命令通过来自患者或看护者的信号启动和停止时被传送。 该系统和方法通过刺激神经通路（8）减少膀胱排空的无意发作的发生率（8），通过增加膀胱容量来减少非自愿膀胱收缩，改善膀胱出口闭合和/或改善泌尿系统的长期健康 和排空之间的时期。 大便失禁的发生率同样减少或消除。 此外，该系统和方法通过使用可以以最小外科手术植入的微型可植入神经刺激器来减少或消除由骶根引起的长期刺激神经通路的盆腔疼痛的发生。 此外，该系统和方法允许患者接受一种或多种神经刺激模式，其可由医师处方并由临床医师进行无持续监督。

公开(公告)号：US5957958A

公开(公告)日：1999-09-28

申请号：US951893

申请日：1997-10-16

申请人： Joseph H. Schulman ,  Gerald E. Loeb ,  Francis J. R. Richmond

发明人： Joseph H. Schulman ,  Gerald E. Loeb ,  Francis J. R. Richmond

IPC分类号： A61N1/05 ,  A61N1/36 ,  A61N1/04

CPC分类号： A61N1/0541 ,  A61N1/36032

摘要： An implant stimulator device uses tantalum and tantalum pentoxide as a system for the conveyance of electrical stimulation pulses from stimulus-forming circuitry contained within an hermetic enclosure to the saline fluids of body tissue to be stimulated. Internal coupling capacitors are not used, yet the danger of having DC current flow to the saline fluids is eliminated. A preferred embodiment provides a multiplicity of electrode contacts made from sintered, anodized tantalum, connected via tantalum wire leads to tantalum feedthroughs into the hermetically sealed package containing the stimulus pulse-forming electronic circuitry. One or more counter electrode contacts (for monopolar or bipolar configurations, respectively) made of activated iridium, non-activated iridium, iridium in combination with a noble or non-noble metal, platinum, gold, or other metal which forms a low impedance contact with body fluids, is/are connected via platinum or other conductive metal leads to return feedthroughs. When powered-up, the stimulus generating circuit produces a steady polarizing potential of approximately half its maximum output voltage range, which potential is applied as a positive (anodizing) voltage to each tantalum electrode and associated lead and feedthrough, with respect to the counter electrode(s), which act as the reference point for the circuit.

摘要翻译： 植入刺激装置使用钽和五氧化二钽作为用于将包含在密封外壳内的刺激形成电路的电刺激脉冲传送到待刺激的身体组织的盐水流体的系统。 不使用内部耦合电容器，但是消除了将直流电流流向盐水流体的危险。 优选实施例提供了由烧结的阳极氧化钽制成的多个电极触点，其通过钽线引线连接到钽馈通到包含刺激脉冲形成电子电路的密封封装中。 一个或多个反电极触点（分别用于单极或双极结构）由活性铱，非活化铱，铱与贵金属或非贵金属，铂，金或其它金属组合制成，形成低阻抗接触 与体液通过铂或其他导电金属引线连接以返回馈通。 当加电时，刺激产生电路产生大约其最大输出电压范围的一半的稳定极化电位，该电位作为阳极（阳极氧化）电压施加到每个钽电极和相关联的引线和馈通，相对于对电极 （s），其作为电路的参考点。