Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems
Patent
1996-06-13
1998-05-19
Getzow, Scott M.
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical therapeutic systems
A61N 108
Patent
active
057529787
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The present invention relates to a method of inducing micturition in individuals who are otherwise with a diminished ability or without the ability to do so. This application is U.S. Pat. No. 5,370,670, which is incorporated herein by reference.
BACKGROUND OF THE INVENTION
Functional neuromuscular electrical stimulation (FNS) to restore control over deficient muscular functions has been used as a clinical treatment of motor deficiencies for the last 20 years (Hambrecht, F. T., Reswick, J. B., (eds): Functional Electrical Stimulation: Application in Neural Prostheses. New York N.Y., Marcel Dekker, 1977). Applications include respiratory assistance by stimulation of the diaphragm in quadriplegic patients, and neuroprosthesis of the arms and legs (Hambrecht, F. T., Reswick, J. B., (eds): Functional Electrical Stimulation: Application in Neural Prostheses. New York N.Y., Marcel Dekker, 1977; Mortimer, J. T.: Motor prostheses, in Brooks (ed): Handbook of Physiology, the Nervous System. Motor Control, Bethsda, Md., 1984 Am Physiol. Soc. 2:155-187; Salmons, S. and Vrbova, G. 1969 J. Physiol. 201:535). Some of these studies have indicated that changes in muscle function occur based on the stimulation. It is known that muscle fiber composition and resulting physiologic and metabolic characteristics (force, contraction and relaxation times) depend on neural activity (Salmons, S. and Vrbova, G. 1969 J. Physiol. 201:535). By electrically controlling nerve and muscle activation, improved fatigue-resistance of atrophic, paralyzed muscles in quadriplegic patients has been reported (Peckham, H. et al. 1976 Clin. Orthop. 114:326.)
In most FNS applications, electrical stimulation is applied to muscles in situ to restore or supplement function. Recently, researchers have evaluated the use of FNS to control the function of heterotopically transferred skeletal muscles. In some cases, the muscle may perform or work very differently from its original function. Dynamic cardiomyoplasty is a procedure in which a skeletal muscle graft is applied to the myocardium and trained to contract in synchrony with the heart muscle (Chachques, J. C., et al. 1988 Circulation 78:203 (Suppl 3); Acker, M. A., et al. 1987 Science 236:324; Magovern, G. J., et al. 1988 Ann Thorac. Surg. 45:614). The first clinical cardiomyoplasty was performed in 1985 (Carpentier, A. and Chacques, J. C.: 1985 Lancet 1:1267). In the approach followed by those investigators, the latissimus dorsi muscle was conditioned to behave like a cardiac muscle by slowly increasing muscle work to adapt to a new cardiac-like function. It is estimated that over 100 cardiomyoplasties have been performed world-wide and may represent an important role in the treatment of congestive heart failure.
In the 1960's the concept of the application of functional electrical stimulation in urology began to emerge. Direct bladder surface stimulation was attempted in order to induce micturition by a patient. However, many clinicians became disenchanted because the high current required would spread to the pelvic floor mixture, causing pain and contraction of the external sphincter during micturition. Device failure was common and a fibrocapsule often developed around the bladder electrodes (Alexander, S. and Rowan, D., 1968 Br. J. Surg., 55:358; Boyce, W. H., et al. 1964 J. Urol., 91:41; Merrill, D. C. 1974 J. Urol. 112:823; Merrill, D. C. and Conway, C. J. 1974 J. Urol. 112:52; and, Timm, G. W. and Bradley, W. E. 1969 Invest. Urol. 6:562).
Throughout the 1970 and 1980's, research toward bladder stimulation was directed toward sacral anterior root stimulation in conjunction with selective or complete sacral deafferentation (Brindley, G. S. et al. 1986 J. Neurol. Neurosurg. & Psychiatry 49:1104; and, Tanagho, E. A. et al. 1989 J. Urol. 142:340). Sacral anterior root stimulation requires intact sacral motor roots and a detrusor capable of contraction.
The use of the rectus muscle to assist manual-compression bladder emptying has been reported (Zhang, Yu-Hai et al., 1990 J.
REFERENCES:
patent: 4205671 (1980-06-01), Lassen
patent: 5188104 (1993-02-01), Wernicke et al.
patent: 5199430 (1993-04-01), Fang et al.
patent: 5231997 (1993-08-01), Kikuchi et al.
patent: 5370670 (1994-12-01), Chancellor
Acker, M. et al., "Skeletal Muscle as the Potential Power Source for a Cardiovascular Pump: Assessment in Vivo", Science 1987, 236, 324-327.
Alexander, S. And Rowan, "Electrical Control of Urinary Incontinence by Radio Implant", Brit. J. Surg. 1968, 55, 358-364.
Boyce, W. et al., "Research Related to the Development of an Artificial Electrical Stimularo for the Paralyzed Human Bladder: A Review", The J. of Urology 1964, 91(1), 41-51.
Brindley, G.S. et al., "Sacral Anterior Rott Simulators for Bladder Control in Paraplegia: the First 50 Cases", J. of Neurology, Neurosurgery and Psychiatry 1986, 49, 1104-1114.
Buyukunal, S.N.C. et al., "An Alternative Treatment Modality in Closing Bladder Exstrophy: Use of Rectus Abdominus Muscle Flap--Preliminary Results in a Rat Model", J. Of Pediatric Surg. 1989, 24(6), 586-589.
Carpentier et al., "Myocardial Substitution with a Stimulated Skeletal Muscle: First Successful Clinical Case", Lancet 1985, 1, 1267.
Chachques et al., "Effect of Latissimus Dorsi Dynamic Cardiomyoplasty on Ventricular Function", Circulation 1988, 78, 203-216.
Magovern, G. et al., "Paced Skeletal Muscle for Dynamic Cardiomyoplasty", Ann. Thorac. Surg. 1988, 45, 614-619.
Merrill, D.C. et al., "Clinical Experience with the Mentor Bladder Stimulator. II. Meningomyelocele Patients", J. Urol. 1974, 112, 823-825.
Merrill et al., "Clinical Experience with the Mentor Bladder Stimulator. I. Patients with Upper Motor Neuron Lesions", J. Urol. 1974, 112, 52-56.
Peckham, P.H. et al., "Alteration in the Force and Fatigability of Skeletal Muscle in Quadriplegic Human Following Exercise Induced by Chronic Electrical Stimulation", Clin. Orthop. 1976, 114, 326-334.
Rivlin, A.S. et al., "Objective Clinical Assessment of Motor Funciton after Experimental Spinal Cord Injury in the Rat", J. Neurosurg. 1977, 47, 577-581.
Salmons, S. et al., "The Influence of Activity of Some Contractile Characteristics of Mammalian Fast and Slow Muscles", J. Physiol. 1969, 201, 535-549.
Tanagho, E.A. et al., "Neural Stimulation for Control of Voiding Dysfunctions: A Preliminary Report in 22 Patients with Serious Neuropathic Voiding Disorders", J. Urol. 1989, 142, 340-345.
Tarlov, I.M., "Spinal Cord Compression Studies", Arch. Neurol. Psychiatry 1954, 71, 588-597.
Timm, G.W. and Bradley, "Electrostimulation of the Urinary Detrusor to Effect Contraction and Evacuation", Invest. Urol. 1969, 6, 562-568.
Yu-Hai, Z. et al., "Enveloping the Bladder with Displacement of Flap of the Rectus Abdominis Muscle for the Treatment of Neurogenic Bladder", J. Urol. 1990, 144, 1194-1195.
Getzow Scott M.
Thomas Jefferson University
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