INCONTINENCE THERAPY OBJECTIFICATION

• US 20110118805A1
• Filed: 10/21/2010
• Published: 05/19/2011
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Wei, Xuan, Bonde, Eric H.
• Granted Patent: US 8,521,292 B2
• Time in Patent Office: Days
• US Class Current: 607/41
• CPC Class Codes: A61N 1/0514 Electrodes for the urinary tract
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data

Abstract

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, objective incontinence information is generated based upon the trigger events. The system and/or user may then use this objective incontinence information to adjust therapy or select new therapy programs for improved efficacy.

Claims

1. A method comprising:

with a processor, generating incontinence information based upon at least one trigger event, wherein a second stimulation therapy is delivered to a patient to generate a second physiological effect based upon the at least one trigger event after beginning delivery of a first stimulation therapy to generate a first physiological effect that is different than the second physiological effect, wherein the first and second stimulation therapies are configured to manage at least one of urinary incontinence or fecal incontinence; and

presenting the incontinence information to a user.

2. The method of claim 1, wherein the trigger event initiates at least one of temporary delivery of the second stimulation therapy in addition to the first stimulation therapy or a temporary amplitude increase of the first stimulation therapy to deliver the second stimulation therapy.

3. The method of claim 1, wherein presenting the incontinence information comprises presenting the incontinence information on a display of an external programmer.

4. The method of claim 1, wherein presenting the incontinence information comprises presenting a graphical representation of the incontinence information.

5. The method of claim 1, wherein the incontinence information comprises at least one of a trend, a frequency, or a number of trigger events or clusters of trigger events over time, time durations between clusters of trigger events, a time duration between a voluntary voiding event of the patient and a first subsequent trigger event or cluster of trigger events, a time duration between individual trigger events in a cluster, a number of trigger events associated with a common cluster, a ranking of clusters of trigger events based upon a number or frequency of trigger events within each cluster, a number or frequency of clusters of trigger events associated with a therapy program, a number or frequency of trigger events or clusters of trigger events associated with time of day, a number or frequency of trigger events of clusters of trigger events associated with at least one type of patient activity, or a number or frequency of trigger events of clusters of trigger events associated with at least one physiological parameter of the patient.

6. The method of claim 1, further comprising receiving the at least one trigger event from at least one of a sensor that indicates a bladder condition, an activity sensor that indicates a patient activity level or posture, or a patient.

7. The method of claim 6, further comprising associating the at least one trigger event with a therapy program that defines the first stimulation therapy delivered when the at least one trigger event occurred.

8. The method of claim 1, further comprising:

presenting a plurality of incontinence therapy programs to the user; and

receiving a therapy program selection from the user that selects at least one therapy program from the plurality of incontinence therapy programs for subsequent delivery of the first stimulation therapy.

9. The method of claim 1, further comprising automatically selecting therapy program to define subsequent first stimulation therapy for the patient, wherein the therapy program is selected from a group of evaluated therapy programs and is associated with a relatively fewest number of trigger events.

10. The method of claim 1, wherein the first physiological effect comprises inhibiting contraction of a bladder of the patient, and the second physiological effect comprises promoting contraction of one or more of a bladder outlet of the patient, an internal urinary sphincter of the patient, an external urinary sphincter of the patient, or periurethral muscles of the patient.

11. A system comprising:

a processor configured to generate incontinence information based upon the at least one trigger event, wherein a second stimulation therapy is delivered to a patient to generate a second physiological effect based upon the at least one trigger event after beginning delivery of a first stimulation therapy to generate a first physiological effect that different than the second physiological effect, and the first and second stimulation therapies are configured to manage at least one of urinary incontinence or fecal incontinence; and

a user interface that presents the incontinence information to a user.

12. The system of claim 11, further comprising a therapy delivery module that, based upon the at least trigger event, at least one of temporarily delivers the second stimulation therapy in addition to the first stimulation therapy or temporarily increases an amplitude of the first stimulation therapy to deliver the second stimulation therapy.

13. The system of claim 11, further comprising an external programmer comprising the user interface, the user interface comprising a display configured to present the incontinence information on the display of the external programmer.

14. The system of claim 11, wherein the processor generates a graphical representation of the incontinence information.

15. The system of claim 11, wherein the incontinence information comprises at least one of a trend, a frequency, or a number of trigger events or clusters of trigger events over time, time durations between clusters of trigger events, a time duration between a voluntary voiding event of the patient and a first subsequent trigger event or cluster of trigger events, a time duration between individual trigger events in a cluster, a number of trigger events associated with a common cluster, a ranking of clusters of trigger events based upon a number or frequency of trigger events within each cluster, a number or frequency of clusters of trigger events associated with a therapy program, a number or frequency of trigger events or clusters of trigger events associated with time of day, a number or frequency of trigger events of clusters of trigger events associated with at least one type of patient activity, or a number or frequency of trigger events of clusters of trigger events associated with at least one physiological parameter of the patient.

16. The system of claim 11, further comprising at least one of a bladder sensor that indicates a bladder condition or an activity sensor that indicates a patient activity level or posture, wherein the processor generates the at least one trigger event based upon signals received from the bladder sensor or activity sensor.

17. The system of claim 11, wherein the user interface receives an incontinence therapy adjustment input from a patient, the trigger event comprising the incontinence therapy adjustment.

18. The system of claim 11, wherein the processor associates the at least one trigger event with a therapy program that defines the first stimulation therapy delivered when the at least one trigger event occurred.

19. The system of claim 11, wherein the processor is configured to present a group of evaluated incontinence therapy programs to the user via the user interface, and receive a therapy program selection from the user via the user interface, the therapy program selection indicating a therapy program from the group of evaluated incontinence therapy programs for subsequent delivery of first stimulation therapy.

20. The system of claim 11, wherein the processor automatically selects a therapy program to define subsequent first stimulation therapy for the patient, wherein the processor selects the therapy program from a plurality of incontinence therapy programs that is associated with a fewest number of trigger events.

21. The system of claim 11, wherein the first physiological effect comprises inhibiting contraction of a bladder of the patient, and the second physiological effect comprises promoting contraction of one or more of a bladder outlet of the patient, an internal urinary sphincter of the patient, an external urinary sphincter of the patient, or periurethral muscles of the patient.

22. The system of claim 11, wherein the processor comprises a first processor, the system further comprising:

a therapy delivery module that generates and delivers the first electrical stimulation therapy to a patient to generate the first physiological effect and the second electrical stimulation therapy to the patient to generate the second physiological effect that is different than the first physiological effect

a second processor that controls the therapy delivery module to deliver the second stimulation therapy based on received input, wherein the first and second electrical stimulation therapies are configured to manage one of urinary incontinence or fecal incontinence.

23. A system comprising:

means for generating incontinence information based upon at least one trigger event, wherein a second stimulation therapy is delivered to a patient to generate a second physiological effect based upon the at least one trigger event after beginning delivery of a first stimulation therapy to generate a first physiological effect that is different than the second physiological effect, wherein the first and second stimulation therapies are configured to manage at least one of urinary incontinence or fecal incontinence; and

means for presenting the incontinence information to a user.

24. The system of claim 23, wherein the trigger event initiates at least one of temporary delivery of the second stimulation therapy in addition to the first stimulation therapy or a temporary amplitude increase of the first stimulation therapy to deliver the second stimulation therapy.

25. The system of claim 23, wherein the incontinence information comprises at least one of a trend, a frequency, or a number of trigger events or clusters of trigger events over time, time durations between clusters of trigger events, a time duration between a voluntary voiding event of the patient and a first subsequent trigger event or cluster of trigger events, a time duration between individual trigger events in a cluster, a number of trigger events associated with a common cluster, a ranking of clusters of trigger events based upon a number or frequency of trigger events within each cluster, a number or frequency of clusters of trigger events associated with a therapy program, a number or frequency of trigger events or clusters of trigger events associated with time of day, a number or frequency of trigger events of clusters of trigger events associated with at least one type of patient activity, or a number or frequency of trigger events of clusters of trigger events associated with at least one physiological parameter of the patient.

26. A computer-readable medium comprising one or more instructions that cause a processor of a computing device to:

generate incontinence information based upon at least one trigger event, wherein a second stimulation therapy is delivered to a patient to generate a second physiological effect based upon the at least one trigger event after beginning delivery of a first stimulation therapy to generate a first physiological effect that is different than the second physiological effect, wherein the first and second stimulation therapies are configured to manage at least one of urinary incontinence or fecal incontinence; and

present the incontinence information to a user.

27. The computer-readable medium of claim 26, wherein the incontinence information comprises at least one of a trend, a frequency, or a number of trigger events or clusters of trigger events over time, time durations between clusters of trigger events, a time duration between a voluntary voiding event of the patient and a first subsequent trigger event or cluster of trigger events, a time duration between individual trigger events in a cluster, a number of trigger events associated with a common cluster, a ranking of clusters of trigger events based upon a number or frequency of trigger events within each cluster, a number or frequency of clusters of trigger events associated with a therapy program, a number or frequency of trigger events or clusters of trigger events associated with time of day, a number or frequency of trigger events of clusters of trigger events associated with at least one type of patient activity, or a number or frequency of trigger events of clusters of trigger events associated with at least one physiological parameter of the patient.