Urinary control

• US 3,870,051 A
• Filed: 04/26/1973
• Issued: 03/11/1975
• Est. Priority Date: 04/27/1972
• Status: Expired due to Term

• Current Assignee: Giles Skey Brindley
• Original Assignee: Giles Skey Brindley
• Inventors: Brindley, Giles Skey
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US05/354,910
• Time in Patent Office: 684 Days
• Field of Search: 128/419E,419R,421,422,DIG.25
• US Class Current: 607/40
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: Y10S 128/25 Artificial sphincters and devices for controlling urinary incontinence

Abstract

Urinary control by electrical stimulation of the sphincter and bladder muscles is effected by way of the sacral ventral roots, selection in the resultant muscle action being effected by use of discriminating signal forms. Sphincter closure action is effected by use of a low intensity pulse train whereby the sphincter is stimulated but not the bladder and so incontinence is avoided. Bladder muscle action to cause micturation is effected by use of a higher intensity pulse train whereby both muscles are stimulated during each pulse train, but during each interruption the sphincter relaxes while the bladder remains contracted.

Claims

1. A method of urinary control which comprises applying an electrical signal of continuous pulse train form to the sacral ventral roots, said sacral ventral roots communicating with the sphincter muscle and bladder muscle, thereby causing the step of contracting said sphincter muscle while said bladder muscle is relaxed.

2. A method according to claim 1 wherein said pulse train has a pulse repetition rate of about 20 per second.

3. A method of urinary control which comprises applying an electrical signal of interrupted pulse train form to the sacral ventral roots, said sacral ventral roots communicating with the sphincter muscle and bladder muscle, thereby causing the step of contracting both of said muscles during each pulse train and the further step of maintaining said bladder muscle contracted during part of each interruption period between successive pulse trains when said sphincter muscle is relaxed.

4. A method according to claim 3 wherein said pulse trains are of short duration during successive intervals of about 1 1/2 seconds, and each comprise about twelve pulses.

5. A method according to claim 4 wherein each of said pulse trains comprises pulses of about 1/2 millisecond duration each 10 milliseconds.

6. A method of urinary control which comprises alternatively applying two different pulsatile electrical signals to the sacral ventral roots, said sacral ventral roots communicating with the sphincter muscle and bladder muscle to thereby cause the step of stimulating said muscles, one of said signals being of lower intensity and higher repetition rate for causing the step of contracting said sphincter muscle while said bladder muscle is relaxed, and the other signal being of higher intensity and lower repetition rate for causing the step of contraction of both of said muscles during each pulse and to cause the further step of maintaining said bladder muscle contracted during part of successive inter-pulse periods when said sphincter muscle is relaxed.

7. A method of urinary control in primates, comprising:

applying pulsing electrical signals to the sacral ventral roots which control contraction of the detrusor muscle for the bladder and the striated, sphincter muscles which contribute to closing the urethra, in two different modes;

in the first of which, the signals are of a first intensity for the step of contracting the urethra closing muscles, but not contracting the bladder detrusor muscle, and including the step of spacing the first intensity pulses such that the urethra closing muscles do not become substantially relaxed between pulses; and

in the second of which, the signals are of a second intensity higher than said first intensity signals for causing the step of contracting both the urethra closing muscles and the bladder detrusor muscle, and including the step of spacing the second intensity pulses such that the urethra closing muscles, but not the bladder detrusor muscle become relaxed between pulses, such that pressure exerted on the bladder by the detrusor muscle in between pulses when the urethra closing muscles have relaxed, forces urine from the bladder and out through the urethra.

8. The method of claim 7, wherein the applying step comprises:

implanting in the subject primate;

a. electrode means disposed for stimulating the third and fourth, left and right sacral ventral motor nerve fibre roots, without substantially stimulating sensory nerve fibres;

b. multivibrator means and an electrical power supply therefor, for emitting said first intensity signals and a connection for communicating these signals to said electrode means;

c. inhibiting means for preventing communication of said first intensity signals to said electrode means upon command;

d. receiver means for receiving a command signal from outside the subject primate and connected to the inhibiting means for commanding same;

e. multivibrator means for emitting said second intensity signals and a connection for communicating these signals to said electrode means;

f. receiver means for receiving a command signal from outside the subject primate and connected to the multivibrator means to emit said second intensity signals;

wherein changing modes from the first to the second comprises;

sending command signals from outside the subject primate to the receiver means of (d) and to the receiver means of (f); and

wherein changing modes from the second to the first comprises;

terminating the sending of said command signals from outside the subject primate.

9. The method of claim 8, wherein:

the implanted multivibrator means of (b) includes electrical output intensity adjustment means and the method further comprises;

post operatively adjusting the intensity of signals provided by the implanted multivibrator means of (b) by adjusting the intensity adjustment means to ensure desired first mode operation wherein thEre occurs contraction of the striated, sphincter muscles which contribute to closing the urethra without substantially contracting the bladder detrusor muscle.

10. Urinary control apparatus comprising:

a. stimulating electrode devices adapted for connection to the sacral ventral roots;

b. a first electrical circuit means operable to generate a low intensity, continuous pulse train signal, which circuit means is connected to said electrode devices to energize the same;

c. a second electrical circuit means operable to generate a high intensity, interrupted pulse train signal, which circuit means is connected to said electrode devices to energize the same; and

d. means for alternatively activating said first and second circuit means to energize said electrode devices;

e. said electrode devices and at least part of both said first and second circuit means being adapted for bodily implantation, and at least part of said activating means being for use outside the body.

11. Urinary control apparatus comprising:

a. stimulating electrode devices adapted for connection to the sacral ventral roots;

b. an implantable electric circuit means, including a power source, operable to generate a low intensity continuous pulse train signal, which circuit means is connected to said electrode devices to energize the same;

c. radio transmitter means for use outside the body operable to generate a first signal including at least a high intensity interrupted pulse train and a second signal;

d. an implantable first radio receiver means operable in response to said interrupted pulse train and connected to said electrode devices to energize the same; and

e. an implantable second radio receiver means operable in response to said second signal and connected to said electric circuit to inhibit operation of the same.