Drug delivery to iliohypogastric nerve to alleviate chronic pelvic pain

• US 20070253998A1
• Filed: 04/28/2006
• Published: 11/01/2007
• Est. Priority Date: 04/28/2006
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gerber, Martin, Giftakis, Jonathon
• Application Number:
  US11/414,505
• Publication Number:
  US 20070253998A1
• Time in Patent Office: Days
• US Class Current: 424/422
• CPC Class Codes: A61K 31/485 Morphinan derivatives, e.g. morphine, codeine
• CPC Class Codes: A61K 31/7076 containing purines, e.g. adenosine, adenylic acid
• CPC Class Codes: A61K 38/31 Somatostatins
• CPC Class Codes: A61M 2005/1405 Patient controlled analgesia [PCA]
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2210/1021 Abdominal cavity
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient

Abstract

The disclosure describes a method and system for delivering a drug to an iliohypogastric nerve of a patient. The system includes drug delivery devices that deliver one or more drugs for alleviation of pelvic pain. The system may deliver drug therapy for pelvic pain in men or women. Drug therapy may made be delivered at various locations along a single or both iliohypogastric nerves of a patient via a fluid transfer device. In some embodiments, electrical stimulation may be applied in combination with drug therapy to one or both iliohypogastric nerves of a patient.

Claims

1. A method comprising delivering a drug to an iliohypogastric nerve of a patient via an implanted drug delivery device.

2. The method of claim 1, wherein the drug is delivered to the iliohypogastric nerve at a point prior to the iliohypogastric nerve branching to form an anterior cutaneous nerve branch and a lateral cutaneous nerve branch.

3. The method of claim 1, wherein the drug is delivered to at least one of an anterior cutaneous nerve branch and a lateral cutaneous nerve branch of the iliohypogastric nerve.

4. The method of claim 1, wherein the drug is delivered to first and second iliohypogastric nerves of a patient via at least the implanted electrical stimulation device.

5. The method of claim 1, wherein the drug is selected to alleviate pelvic pain.

6. The method of claim 5, wherein the pelvic pain includes at least one of chronic groin pain, chronic testicular pain (CTP), post vasectomy pain, iliohypogastric neuralgia, vulvodynia, and interstitial cystitis.

7. The method of claim 1, wherein the drug comprises at least one of gabapentin, morphine, clonidine, tizanidine, hydromorphone, fentanyl, sufentanil, methadone, meperidine, tetracaine, bupivicaine, zinconotide, adenosine, ketorolac, baclofen, ropivicaine, ketamine, octreotide, neostigmine, and droperidol.

8. The method of claim 1, wherein the implanted drug delivery device comprises a reservoir for storing the drug and a fluid transfer device coupled to the reservoir, and wherein delivering the drug comprises delivering the drug from the reservoir to the iliohypogastric nerve via the fluid transfer device.

9. The method of claim 1, further comprising delivering electrical stimulation to the iliohypogastric nerve of the patient via an implanted electrical stimulation device.

10. The method of claim 9, wherein delivering electrical stimulation comprises delivering electrical stimulation to first and second iliohypogastric nerves of the patient via the implanted electrical stimulation device.

11. The method of claim 9, wherein the electrical stimulation is selected to alleviate pelvic pain.

12. The method of claim 9, wherein the electrical stimulation device includes a stimulation pulse generator within a common housing with a pump associated with the implanted drug delivery device.

13. The method of claim 9, further comprising delivering the electrical stimulation to at least one of the hypogastric nerves and at least one of a ilioinguinal nerve and a genital nerve branch of a genitofemoral nerve.

14. The method of claim 1, further comprising delivering the drug to at least one of the hypogastric nerves and at least one of a ilioinguinal nerve and a genital nerve branch of a genitofemoral nerve.

15. A system comprising:

an implantable drug delivery system that delivers a drug selected to alleviate pelvic pain to at least one iliohypogastric nerve of a patient; and

an implantable electrical stimulation system that delivers electrical stimulation selected to alleviate pelvic pain to at least one iliohypogastric nerve of the patient.

16. The system of claim 15, wherein the drug is selected to alleviate pelvic pain including at least one of chronic groin pain, chronic testicular pain (CTP), post vasectomy pain, iliohypogastric neuralgia, vulvodynia, and interstitial cystitis.

17. The system of claim 15, wherein the drug comprises at least one of gabapentin, morphine, clonidine, tizanidine, hydromorphone, fentanyl, sufentanil, methadone, meperidine, tetracaine, bupivicaine, zinconotide, adenosine, ketorolac, baclofen, ropivicaine, ketamine, octreotide, neostigmine, and droperidol.

18. The system of claim 15, wherein the implantable drug delivery device comprises:

a reservoir that stores the drug;

a fluid transfer device to transfer the drug from the reservoir to the iliohypogastric nerve, the fluid transfer device having a proximal end for receiving the drug from the reservoir and a distal end for delivering the drug to the delivery site; and

a pump unit coupling the reservoir to the proximal end of the fluid transfer device that causes the transfer of the drug from the reservoir to the delivery site via the fluid transfer device.

19. The system of claim 15, further comprising a processor that controls both the drug delivery device and the electrical stimulation device.

20. The system of claim 15, wherein the drug delivery device and the electrical stimulation device include a common housing.

21. The system of claim 15, wherein the fluid transfer device is positioned to deliver the drug to the iliohypogastric nerve at a point prior to the iliohypogastric nerve branching to form an anterior cutaneous nerve branch and a lateral cutaneous nerve branch.

22. The system of claim 15, wherein the fluid transfer device is positioned to deliver the drug to at least one of an anterior cutaneous nerve branch and a lateral cutaneous nerve branch of the iliohypogastric nerve.

23. The system of claim 15, wherein the electrical stimulation device includes a stimulation pulse generator within a common housing with a pump associated with the implanted drug delivery device.

24. A method comprising:

delivering a fluid to at least one iliohypogastric nerve of a patient via an implanted fluid delivery device; and

delivering electrical stimulation to at least one iliohypogastric nerve of a patient via an implanted electrical stimulation device,

wherein the implanted fluid delivery device and the implanted electrical stimulation device share a common housing.

25. The method of claim 24, wherein delivering a fluid includes delivering a drug via a catheter coupled to the common housing, and delivering electrical stimulation includes delivering the electrical stimulation via a lead coupled to the common housing.

26. A system comprising:

an implantable fluid delivery device that delivers a fluid selected to alleviate pelvic pain to at least one iliohypogastric nerve of a patient; and

an implantable electrical stimulation device that delivers electrical stimulation selected to alleviate pelvic pain to at least one iliohypogastric nerve of the patient,

wherein the implanted fluid delivery device and the implanted electrical stimulation device share a common housing.

27. The system of claim 26, further comprising a catheter coupled to the common housing to deliver the fluid, and a lead coupled to the common housing to deliver the electrical stimulation.

28. A method comprising delivering at least one of a drug and electrical stimulation to at least two or more of an iliohypogastric nerve, an ilioinguinal nerve, and an genitofemoral nerve of a patient via an implanted medical device.

29. The method of claim 28, wherein the drug is selected to alleviate pelvic pain.

30. The method of claim 28, wherein the electrical stimulation is selected to alleviate pelvic pain.

31. The method of claim 28, further comprising delivering both the drug and the electrical stimulation to two or more of the iliohypogastric nerve, ilioinguinal nerve, and genitofemoral nerve.