US3650276A - Method and apparatus, including a flexible electrode, for the electric neurostimulation of the neurogenic bladder - Google Patents

Method and apparatus, including a flexible electrode, for the electric neurostimulation of the neurogenic bladder Download PDF

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Publication number
US3650276A
US3650276A US810167A US81016769A US3650276A US 3650276 A US3650276 A US 3650276A US 810167 A US810167 A US 810167A US 81016769 A US81016769 A US 81016769A US 3650276 A US3650276 A US 3650276A
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United States
Prior art keywords
foil
wires
bladder
insulating material
electromagnetic field
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Expired - Lifetime
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US810167A
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English (en)
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Theodor Burghele
Vasile Ichim
Mihai Demetrescw
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INST DEMEDICINA SI FARMACIE
INSTITUTUL DEMEDICINA SI FARMACIE
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INST DEMEDICINA SI FARMACIE
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/378Electrical supply
    • A61N1/3787Electrical supply from an external energy source
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes

Definitions

  • ABSTRACT [211 Appl. No.: 810,167
  • a method for artificial voiding of the bladder involves the introduction of electrodes onto the motor nerves of the bladder, and placing on the anterior wall of the sacrum a receiver U.S. E, means for producing an electric current within uch elec- [51] Int. Cl. ..A6ln 1/36 trodes when excited by an electromagnetic field, and periodi- [58] Field of Search ..128/4l8, 419, 421, 422 cally applying an electric and an electromagnetic field from the exterior of the body to said receiver means to induce voiding of the bladder.
  • the invention relates to a method and an apparatus for the electric neurostimulation from a distance of the neurogenic bladder following spinal cord injuries as well as other affections of the nervous system.
  • Another direct electric stimulation of the bladder muscle is known, which consists in its stimulation with electrodes of stainless steel wires or disks fixed on the bladder wall, electrodes which are bound to a receiver surgically applied under the skin, and started by an external transmitter with small power of penetrability.
  • this method presents the disadvantage of producing pain during the stimulation, contractions of the lower extremities and abdomen muscles, burns and scars at the stimulation site as well as perforations of the bladder wall, the interruption of the conductors by motion, all drawbacks that counterindicate or limit the possibility of applying this method.
  • the method eliminates the above mentioned disadvantages in that, in order to avoid the catheter drainage, infections, complications and the drawbacks resulting from the application of electric stimuli, on the bladder muscle, the electric stimulation of the bladder motor nerves in man is applied, by using a receiver surgically introduced onto the anterior wall of the sacrum, provided with two bipolar electrodes, one for each pelvic nerve, the electrodes being fixed on these nerves, which receive from the receiver rectangular stimuli having variable parameters, comprised between 5 and ma., an electromotor tension of about 2.5 volts, a frequency of impulses and a stimulus duration up to 7 ms., the stimulus being introduced into the receiver by an electromagnetic field, produced by the antenna of an external transmitter.
  • the apparatus consists of an external inductor, the antenna of which produces an electromagnetic field with great power of penetrability into the body and which exerts an influence on a receiver previously placed onto the anterior wall of the sacrum, composed of an oscillating circuit accorded with the frequency of the external inductor, the secondary circuit of which in feeding a detector a germanium diode) the current being filtered by means of a capacitor and applied at the electrode terminals, electrodes which are wrapped around the nerves.
  • FIGS. l,2,3,4 and 5 represent:
  • FIG. I is a schematic block diagram of apparatus according to the present invention.
  • FIG. 2 is a schematic diagram showing in greater detail the inductor and receiver ofFIG. 1.
  • FIG. 3 is a detail of the position of the receiver and electrodes in the body.
  • F IG. 4 is a schematic detail of the electrodes and of their position on the pelvic nerves.
  • FIG. 5 is a detail of folding of the electrode on the pelvic nerves.
  • the apparatus emitting electromagnetic waves is composed of a generator G (FIG. 1), which produces rectangular impulses with the following characteristic: 5 l0 ma., l5 impulses per second, and a duration of 7 ms.
  • G generator G
  • the generator G by means of a modulator M, modulates an electric current with a frequency of 300 kI-Iz., oscillations supplied by an oscillator 0. Having been amplified by the amplifier P, the electric current reaches an inductor I, the resonant circuit of which produces by means of an exterior antenna A (FIG. 2), an electromagnetic field H with great power of penetrability into the body.
  • the electromagnetic field H exerts an influence on a receiver R, previously fixed on the anterior wall of the sacrum, composed of an resonant circuit LC, (FIG. 2), accorded with the frequency of the exterior inductor, the secondary circuit of which feeds a detector D (germanium diode), the current being then filtered by means of a capacitor C, and applied at the electrode terminals E.
  • a receiver R previously fixed on the anterior wall of the sacrum, composed of an resonant circuit LC, (FIG. 2), accorded with the frequency of the exterior inductor, the secondary circuit of which feeds a detector D (germanium diode), the current being then filtered by means of a capacitor C, and applied at the electrode terminals E.
  • LC resonant circuit
  • the bipolar electrodes (2) composed of two foils (3) and (4) (FIGS. 4 and 5), made of plastics, for instance polyethylene, the external foil (3) being continuous and the interior one 4) being interrupted in the central zone for an adequate distance, two platinum wires (5) being introduced between the foils, so that by folding FIG. 5) an intimate contact with the pelvic nerves surface l) is obtained, in this way the electrode being sewed in two points.
  • the receiver R (FIG. 3) is located on the anterior wall of the sacrum S, retroperitoneally, the pelvic nerves (1) receiving electric stimuli from the electrodes (2) during all the period of time in which the antenna is situated parallel to the receiver and in the area where the receiver is included.
  • Case 1 Patient with accidental fracture of the spine at the level of the X and XI'" thoracic vertebrae. Because of paraplegia with urine retention, drainage with catheter indwelling is carried on. After 3 weeks from the accident, the receiver for the neurostimulation of the bladder is surgically applied, the catheter being taken off.
  • the artificial voiding of the bladder by neurostimulation is performed; the bladder voids without residue and the urine is sterile on culture.
  • the artificial voiding of the bladder by electric neurostimulation is performed.
  • the urine becomes clear and sterile. After 2 months, good results are obtained by voiding with neurostimulation.
  • Urinary infection is present due to permanent catheter drainage in a patient with spinal cord injury and spinal cord section at the level of the VIth thoracic vertebra.
  • Receiver and neurostimulation, with complete bladder voiding are applied, the clearing and sterilization of the urine being obtained.
  • the contraction of the paralyzed bladder as a result of spinal cord injuries or other affections of the nervous system is performed, according to the invention, by electric stimulation with a receiver, insulated with polyethylene, surgically introduced into the body and connected with bipolar electrodes which are placed on the pelvic nerves of the bladder.
  • the receiver is put in action, sending electric stimuli to the pelvic nerves, at the moment when the antenna of an external transmitting apparatus is' brought nearer to the zone where the receiver is included.
  • the voiding of the bladder by electric stimulation of its motor nerves allows the avoiding of the catheter drainage which presents the danger of urinary tract infection with all its subsequent complications.
  • a method for artificial voiding of the bladder comprising (a) surgically introducing electrodes onto the motor nerves for the bladder, (b) surgically placing on the anterior wall of the sacrum receiver means for the producing of an electric current in the electrodes when excited by an electromagnetic field and attaching said receiver means to the electrode to apply the current thereto, generating an electromagnetic field, and (d) periodically applying the electromagnetic field to the receiver means to excite the same and induce voiding of the bladder.
  • the step of introducing electrodes includes the step of folding over a bladder motor nerve the foil of an electrode having two platinum wires attached to a foil of insulating material tolerated by the body and covered with a similar insulating foil on two ends of each wire to leave a central area of each wire uncovered, the foil being folded over the nerve to bring the uncovered region of the wires into contact with the nerve.
  • An electrode for applying electrical stimulation to nerves comprising, in combination:
  • Apparatus for inducing artificial voiding of the bladder comprising, in combination:
  • Receiver means for producing an electric current when stimulated by electromagnetic radiation and being of a size to fit between the sacrum and the bladder of a human body and adapted to be mounted on the anterior wall of the sacrum, and being covered with a material tolerated by the human body, said resonant circuit having a coil with a tap; a first capacitor connected across said coil, detector means connected to the tap of said coil and to one of said electrical wires, the other of said electrical wires being connected to said coil and a second capacitor connected between said electrical wires to form a filter circuit; and
  • each electrode comprising, in combination:
  • a second piece of insulating material attached to the other end of the foil to cover the two wires at the other end of the foil and leave the central region of both wires uncovered.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Cardiology (AREA)
  • Urology & Nephrology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Electrotherapy Devices (AREA)
  • Percussion Or Vibration Massage (AREA)
US810167A 1969-03-26 1969-03-25 Method and apparatus, including a flexible electrode, for the electric neurostimulation of the neurogenic bladder Expired - Lifetime US3650276A (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19691915486 DE1915486A1 (de) 1969-03-26 1969-03-26 Verfahren und Vorrichtung fuer die elektrische Neurostimulation der neurogenen Harnblase

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US3650276A true US3650276A (en) 1972-03-21

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US (1) US3650276A (fr)
CH (1) CH507005A (fr)
DE (1) DE1915486A1 (fr)
FR (1) FR2038813A5 (fr)
NL (1) NL6905627A (fr)

Cited By (79)

* Cited by examiner, † Cited by third party
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US3738368A (en) * 1970-12-14 1973-06-12 R Avery Implantable electrodes for the stimulation of the sciatic nerve
US3788329A (en) * 1972-04-17 1974-01-29 Medtronic Inc Body implantable lead
US3870051A (en) * 1972-04-27 1975-03-11 Nat Res Dev Urinary control
DE2538289A1 (de) * 1974-09-13 1976-03-25 Saul Liss Vorrichtung zur zeitweisen beseitigung arthritischer schmerzen
US4144889A (en) * 1977-05-31 1979-03-20 Research Corporation Cardiac electrodes for temporary pacing
EP0012122A1 (fr) * 1978-11-27 1980-06-11 Gambro Crafon Aktiebolag Stimulateur électrique
US4306564A (en) * 1977-09-22 1981-12-22 Werner Kraus Electrification attachment for an osteo-synthesis implantate
US4323081A (en) * 1980-06-30 1982-04-06 Medtronic, Inc. Pacing lead
US4406288A (en) * 1981-04-06 1983-09-27 Hugh P. Cash Bladder control device and method
US4569351A (en) * 1984-12-20 1986-02-11 University Of Health Sciences/The Chicago Medical School Apparatus and method for stimulating micturition and certain muscles in paraplegic mammals
US4585005A (en) * 1984-04-06 1986-04-29 Regents Of University Of California Method and pacemaker for stimulating penile erection
US4586508A (en) * 1984-03-23 1986-05-06 Cordis Corporation Implant communication system with patient coil
EP0211159A1 (fr) * 1985-05-15 1987-02-25 Dumin Wu Appareil et système pour la génération de signaux d'information vitale
US4700707A (en) * 1985-12-09 1987-10-20 Cordis Corporation Pulse to sine wave/sample decoder telemetry system
US4739764A (en) * 1984-05-18 1988-04-26 The Regents Of The University Of California Method for stimulating pelvic floor muscles for regulating pelvic viscera
US4741340A (en) * 1985-12-18 1988-05-03 Cordis Corporation Pulse to sinewave telemetry system
US4771779A (en) * 1984-05-18 1988-09-20 The Regents Of The University Of California System for controlling bladder evacuation
US5291902A (en) * 1993-01-11 1994-03-08 Brent Carman Incontinence treatment
WO1995012431A1 (fr) * 1993-11-02 1995-05-11 Nauchno-Proizvodstvennaya Kommercheskaya Firma 'yarilo' Methode de biostimulation de la prostate et dispositif prevu a cet effet
US6324435B1 (en) 2000-06-22 2001-11-27 Ethicon, Inc. Electrical connector for cardiac devices
WO2001089629A1 (fr) * 2000-05-26 2001-11-29 Consejo Superior De Investigaciones Científicas Systeme de stimulation des racines sacrales moyennant un implant a alimentation radioelectrique
US20020062140A1 (en) * 2000-11-20 2002-05-23 Demian Bassem M. Bunion treating device
US20020091419A1 (en) * 2000-07-13 2002-07-11 Firlik Andrew D. Methods and apparatus for effectuating a change in a neural-function of a patient
US20030078633A1 (en) * 2001-09-28 2003-04-24 Firlik Andrew D. Methods and implantable apparatus for electrical therapy
US20030097161A1 (en) * 2000-07-13 2003-05-22 Firlik Andrew D. Methods and apparatus for effectuating a lasting change in a neural-function of a patient
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US20030187490A1 (en) * 2002-03-28 2003-10-02 Gliner Bradford Evan Electrode geometries for efficient neural stimulation
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US20040102828A1 (en) * 2002-11-27 2004-05-27 Lowry David Warren Methods and systems employing intracranial electrodes for neurostimulation and/or electroencephalography
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US20040181263A1 (en) * 2001-03-08 2004-09-16 Jeffrey Balzer System and method for treating Parkinson's Disease and other movement disorders
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US20050004624A1 (en) * 2003-04-24 2005-01-06 Gliner Bradford E. Systems and methods for facilitating and/or effectuating development, rehabilitation, restoration, and/or recovery of visual function through neural stimulation
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US20050021118A1 (en) * 2000-07-13 2005-01-27 Chris Genau Apparatuses and systems for applying electrical stimulation to a patient
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US20050033378A1 (en) * 2002-12-09 2005-02-10 Sheffield Warren Douglas Methods for treating and/or collecting information regarding neurological disorders, including language disorders
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US20050060014A1 (en) * 2001-08-31 2005-03-17 Medtronic, Inc. Implantable medical electrical stimulation lead fixation method and apparatus
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US20050075680A1 (en) * 2003-04-18 2005-04-07 Lowry David Warren Methods and systems for intracranial neurostimulation and/or sensing
US6941171B2 (en) 1998-07-06 2005-09-06 Advanced Bionics Corporation Implantable stimulator methods for treatment of incontinence and pain
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US20060106431A1 (en) * 2004-11-12 2006-05-18 Allen Wyler Systems and methods for selecting stimulation sites and applying treatment, including treatment of symptoms of Parkinson's disease, other movement disorders, and/or drug side effects
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NL7415854A (nl) * 1973-12-07 1975-06-10 Medtronic Inc Stelsel voor elektrisch stimuleren van een biologisch systeem.
DE3605915A1 (de) * 1986-02-25 1987-08-27 Telefunken Electronic Gmbh Steuer- und leistungsversorgungseinheit fuer implatierte elektromedizinische mess-, steuer- und regelsysteme
US4920979A (en) * 1988-10-12 1990-05-01 Huntington Medical Research Institute Bidirectional helical electrode for nerve stimulation
US5370670A (en) * 1993-12-13 1994-12-06 Thomas Jefferson University Detrusor myoplasty and neuromuscular electrical stimulation of the urinary bladder

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Cited By (155)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3738368A (en) * 1970-12-14 1973-06-12 R Avery Implantable electrodes for the stimulation of the sciatic nerve
US3788329A (en) * 1972-04-17 1974-01-29 Medtronic Inc Body implantable lead
US3870051A (en) * 1972-04-27 1975-03-11 Nat Res Dev Urinary control
DE2538289A1 (de) * 1974-09-13 1976-03-25 Saul Liss Vorrichtung zur zeitweisen beseitigung arthritischer schmerzen
US4144889A (en) * 1977-05-31 1979-03-20 Research Corporation Cardiac electrodes for temporary pacing
US4306564A (en) * 1977-09-22 1981-12-22 Werner Kraus Electrification attachment for an osteo-synthesis implantate
EP0012122A1 (fr) * 1978-11-27 1980-06-11 Gambro Crafon Aktiebolag Stimulateur électrique
US4323081A (en) * 1980-06-30 1982-04-06 Medtronic, Inc. Pacing lead
US4406288A (en) * 1981-04-06 1983-09-27 Hugh P. Cash Bladder control device and method
US4586508A (en) * 1984-03-23 1986-05-06 Cordis Corporation Implant communication system with patient coil
US4585005A (en) * 1984-04-06 1986-04-29 Regents Of University Of California Method and pacemaker for stimulating penile erection
US4739764A (en) * 1984-05-18 1988-04-26 The Regents Of The University Of California Method for stimulating pelvic floor muscles for regulating pelvic viscera
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