Bladder sensing using impedance and posture

• US 9,327,117 B2
• Filed: 04/20/2010
• Issued: 05/03/2016
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Denison, Timothy J., Miesel, Keith A.
• Primary Examiner(s): Towa, Rene
• Assistant Examiner(s): ABOUELELA, MAY A
• Application Number:
  US13/264,023
• Publication Number:
  US 20120035496A1
• Time in Patent Office: 2,205 Days
• Field of Search: 600/546, 600/547, 600/573, 600/574, 600/579
• US Class Current: 1/1
• CPC Class Codes: A61B 2560/0462 Apparatus with built-in sensors
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/204 Determining bladder volume
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6883 Sutures
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

This disclosure provides techniques for bladder sensing. In accordance with the techniques described in this disclosure, a device may measure the impedance of a bladder, determine the posture of a patient, and determine a status of the bladder based on the impedance and posture.

Claims

1. A method comprising:

receiving, by a processor in a medical device system, a measured impedance value of a urinary bladder of a patient;

receiving, by the processor, a determined posture of the patient; and

determining, with the processor, a filling status of the urinary bladder of the patient based on the measured impedance value of the bladder of the patient and the determined posture of the patient, wherein the measured impedance value is associated with a plurality of filling statuses, the plurality of filling statuses including the determined filling status.

2. The method of claim 1, further comprising:

measuring the impedance value of the bladder of the patient with an implanted medical device; and

wherein receiving a determined posture of the patient comprises;

sensing a signal indicative of a posture of the patient with a posture sensor; and

determining, with the processor, the posture of the patient based on the sensed signal.

3. The method of claim 2, wherein the posture sensor comprises one or more accelerometers, and wherein determining the posture comprises determining the posture based on one or more signals from the one or more accelerometers.

4. The method of claim 2, wherein measuring the impedance value of the bladder of the patient comprises:

emitting an electrical signal via a first electrode implanted proximate to a wall of the bladder at a first location,

receiving the electrical signal via a second electrode implanted proximate to the wall of the bladder at a second location, and

measuring the impedance value of the bladder based on the electrical signal.

5. The method of claim 4, wherein measuring the impedance value of the bladder of the patient further comprises:

measuring a voltage between a third electrode implanted adjacent to the first electrode and a fourth electrode implanted adjacent to the second electrode; and

measuring the impedance value of the bladder based on the electrical signal and the measured voltage.

6. The method of claim 1, wherein the filling status comprises at least one of a volumetric indication of an amount of urine in the bladder or a fill level category.

7. The method of claim 1, wherein determining the filling status of the bladder comprises determining the filling status from a plurality of filling statuses, wherein the filling status is associated with the measured impedance value and the determined posture.

8. The method of claim 1, further comprising generating an alert if the determined filling status indicates a fill level of the bladder above a threshold level.

9. The method of claim 1, further comprising controlling an implanted medical device to deliver therapy to the patient based on the determined filling status.

10. The method of claim 9, wherein the therapy comprises electrical stimulation therapy delivered to at least one of a pelvic floor nerve or a pelvic floor muscle based on the determined filling status.

11. The method of claim 7, wherein each of the plurality of filling statuses is associated with a respective impedance value of the bladder and a respective posture of the patient in a memory, and wherein determining the filling status from the plurality of filling statuses comprises determining the filling status associated with the measured impedance value and the determined posture in the memory.

12. A system comprising:

an implantable medical device comprising an impedance measurement unit configured to measure an impedance value of a urinary bladder of a patient;

a posture sensor configured to sense a signal indicative of a posture of the patient; and

a processor configured to determine the posture of the patient based on the sensed signal and determine a filling status of the bladder based on the measured impedance value and the determined posture, wherein the measured impedance value is associated with a plurality of filling statuses, the plurality of filling statuses including the determined filling status.

13. The system of claim 12, wherein the posture sensor comprises one or more accelerometers, and wherein the processor is configured to determine the posture of the patient based on one or more signals from the one or more accelerometers.

14. The system of claim 12, further comprising:

a first electrode implantable proximate to a wall of a bladder of a patient at a first location; and

a second electrode implantable proximate to the wall of the bladder at a second location,

wherein the impedance measurement unit is electrically coupled to the first electrode and the second electrode, and wherein the impedance measurement unit is configured to emit an electrical signal via the first electrode, receive the electrical signal via the second electrode, and measure an impedance value of the bladder based on the electrical signal.

15. The system of claim 14, further comprising:

a third electrode implantable adjacent to the first electrode and a fourth electrode implantable adjacent to the second electrode,

wherein the impedance measurement unit is configured to measure a voltage between the third and fourth electrodes, and measure the impedance value of the bladder based on the electrical signal and the measured voltage.

16. The system of claim 12, wherein the filling status comprises at least one of a volumetric indication of an amount of urine in the bladder or a fill level category.

17. The system of claim 12, wherein the processor is configured to determine the filling status of the bladder from a plurality of filling statuses, wherein the determined filling status is associated with the measured impedance value and the determined posture.

18. The system of claim 12, wherein the processor is configured to generate an alert if the filling status indicates a fill level above a threshold level.

19. The system of claim 12, wherein the processor is configured to control the implantable medical device to deliver therapy to the patient based on the determined filling status.

20. The system of claim 19, wherein the implantable medical device comprises an electrical stimulation therapy device configured to deliver electrical stimulation to at least one of a pelvic floor nerve or a pelvic floor muscle.

21. The system of claim 17, further comprising a memory, wherein each of the plurality of filling statuses is associated with a respective impedance value of the bladder and a respective posture of the patient in the memory, and wherein the processor is configured to determine the filling status from the plurality of filling statuses based on the measured impedance value and the determined posture in the memory.

22. An implantable medical device comprising:

an impedance measurement unit configured to measure an impedance value of a urinary bladder of a patient;

a posture sensor configured to sense a signal indicative of a posture of the patient; and

a processor configured to determine the posture of the patient based on the sensed signal and determine a filling status of the bladder based on the measured impedance value and the determined posture, wherein the measured impedance value is associated with a plurality of filling statuses, the plurality of filling statuses including the determined filling status.

23. The device of claim 22, wherein the posture sensor comprises one or more accelerometers configured to generate one or more signals indicative of posture, and wherein the processor is configured to determine the posture based on the one or more signals.

24. The device of claim 22, further comprising:

a first electrode implantable proximate to a wall of a bladder of a patient at a first location; and

a second electrode implantable proximate to the wall of the bladder at a second location,

wherein the impedance measurement unit is electrically coupled to the first electrode and the second electrode, and wherein the impedance measurement unit is configured to emit an electrical signal via the first electrode, receive the electrical signal via the second electrode, and measure an impedance value of the bladder based on the electrical signal.

25. The device of claim 24, further comprising:

a third electrode implantable adjacent to the first electrode; and

a fourth electrode implantable adjacent to the second electrode,

wherein the impedance measurement unit is configured to measure a voltage between the third and fourth electrodes and measure the impedance of the bladder based on the electrical signal and the measured voltage.

26. The device of claim 22, wherein the processor is configured to determine the filling status from a plurality of filling statuses, wherein the determined filling status is associated with the measured impedance and the detected posture.

27. The device of claim 22, wherein the processor is configured to generate an alert if the filling status indicates a fill level above a threshold level.

28. The device of claim 22, further comprising a therapy delivery unit, wherein the processor is configured to control the therapy delivery unit to deliver therapy to the patient based on the determined filling status.

29. The device of claim 28, wherein the therapy delivery unit comprises an electrical stimulation therapy unit configured to deliver electrical stimulation to at least one of a pelvic floor nerve or a pelvic floor muscle.

30. An external programmer for an implantable medical device, the programmer comprising:

a telemetry interface configured to receive data indicating a measured impedance value of a bladder of a patient from the implantable medical device; and

a processor configured to determine a posture of the patient and determine a filling status of the bladder of the patient based on the measured impedance value and the determined posture, wherein the measured impedance value is associated with a plurality of filling statuses, the plurality of filling statuses including the determined filling status.

31. The external programmer of claim 30, wherein the telemetry interface is configured to receive posture data indicating the posture of the patient and the processor is configured to determine the posture based on the posture data.

32. The external programmer of claim 30, wherein the filling status comprises at least one of a volumetric indication of an amount of urine in the bladder or a fill level category.

33. The external programmer of claim 30, wherein the processor is configured to determine the filling status from a plurality of filling statuses, wherein the determined filling status is associated with the measured impedance value and the determined posture.

34. The external programmer of claim 30, wherein the processor is configured to at least one of generate an alert if the filling status indicates a fill level above a threshold level or control the implantable medical device to deliver therapy to the patient based on the determined filling status.