Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems
Utility Patent
1999-04-27
2001-01-02
Evanisko, George R. (Department: 3737)
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical therapeutic systems
Utility Patent
active
06169924
ABSTRACT:
FIELD OF THE INVENTION
The present invention generally relates to therapy by spinal cord stimulation and more particularly relates to spinal cord stimulation for the treatment of orgasmic dysfunction.
BACKGROUND
Orgasmic dysfunction is an inhibition of the orgasmic phase of the sexual response cycle. Orgasmic dysfunction is a serious disorder that plagues both women and men. Like all dysfunctions, orgasmic dysfunction may be life long or acquired. The condition is referred to as primary (life-long) when the patient has never experienced orgasm through any means of stimulation. The problem is considered secondary (acquired) if the patient has attained orgasm is the past but is currently non-orgasmic. Situational orgasmic dysfunction in women refers to a woman who can climax through some methods of stimulation, but not through others. The American Psychiatric Association describes the disorder as the “persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity.”
The general theory of normal sexual response cycle involves three phases: desire, excitement, and orgasm. Metaphorically, each phase of the normal sexual response may be thought to have a common generator but each phase also has its own circuitry. This separate neural circuitry creates the possibility for separate and discrete inhibition of the three phases. Certain kinds of trauma, if sufficiently intense, disturb the entire system, but often only one component is disrupted.
Orgasmic dysfunction should be distinguished from the excitement phase of the sexual response cycle. The excitement phase involves the arousal or erection of the sexual organs. There currently are several products, both drug-induced and mechanical, to stimulate and induce the excitement phase.
For example, to treat impotence (also called erectile dysfunction) it is known to implant electrical conductors to the surface of the pelvic splanchnic nerve. Stimulation of this nerve with low voltage electrical pulses is believed to causes arterioles dilation and initiate erection. Also, it is known that implantation of an electrode on the cavernous nerves of a male, adjacent to his prostate gland, may also achieve penile erection. Further, other electrical impulse devices exist that are not implanted but instead applied topically to the coccyx region to promote sexual excitation. Impotence, however, should not be confused with orgasmic dysfunction where satisfactory erection may be obtained but there is an absence of orgasm.
Current treatment of orgasmic dysfunction concentrates on the psychological components of the disorder rather than the physiological components. Orgasmic dysfunction is a physical malady that results in marked distress and interpersonal difficulty. The physical disorder causes psychological performance anxiety and pressure. Sexual desire and frequency usually decline. The patient's intimate relationships ultimately suffer from resentment and conflict.
Although psychological therapy may be required to rebuild confidence and regain the phases of desire and excitement, the orgasm phase requires a physiological solution. A basic tenet of most sex therapies is that an actual physical response will alleviate much of the anxiety associated with the disorder and initiate a positive mental response regarding the other two stages of the sexual cycle. Although it is important in treatment to improve communication and enhance relationships, an initial objective in therapy is the ability to obtain orgasm under any circumstances.
Within the neuromodulating community, there is anecdotal evidence of patients who have experienced mild sensation of the genitalia while undergoing spinal cord stimulation for pain relief.
Spinal cord stimulation, on the other hand, has been used as a treatment for chronic painful conditions for approximately thirty years. Commonly, spinal cord stimulation is used to alleviate pain after failed surgery, pain due to neuropathies, or pain due to inadequate blood flow. Neurostimulation systems have been found to relieve chronic, intractable pain in the limbs or trunk.
The basic concept of neurostimulation as it relates to pain relief involves the substitution of sensations that reach the thalamus of the brain. Rather than a pain message, the spinal cord stimulation closes the gate in the spinal cord and replaces the pain sensation with a tingling sensation. Electrodes are positioned effectively to create parathesia in the painful area.
Parathesia refers to a change in sensation in an area of the body. Usually parathesia is used to show change in neurologic function caused by damage to a nerve or nerves. Parathesia is usually not an absence of sensation but a decrease or alteration of sensation. Patients have described parathesia as a “buzzing sensation.”
Parathesia is accomplished through the implantation of stimulating electrodes within the spinal canal. The electrodes are inserted between the vertebrae in parallel with the spinal cord. Low-voltage electrical stimulation is precisely applied to the spinal cord. Through direct stimulation of the dorsal column or the targeted peripheral nerve, the sensation of pain is replaced by a more pleasant “tingling” sensation.
The sensation can be adjusted in terms of amplitude to control intensity, pulse width to control duration and frequency. Further, the neurostimulation system is implantable in its entirety. Medtronic Neurological, a division of Medtronic, Inc. of Minneapolis, Minn. sells a neurostimulator system used for pain relief. The device has been approved by the Federal Drug Administration for implantation in the spinal cord to effectively alleviate pain.
Heretofore, spinal cord stimulation has not been used to treat orgasmic dysfunction. There exists a need, however, to effectively treat orgasmic dysfunction through a physiological approach.
SUMMARY
The present invention for the first time, recognizes that carefully placed and controlled spinal cord stimulation may be used to treat orgasmic dysfunction. Stimulating electrodes are placed in the spinal canal via a needle inserted between the appropriate vertebrae in parallel with the spinal cord. The electrodes are connected to a power source. Through variable transmission of radio frequency waves a patient suffering from orgasmic dysfunction may once again achieve orgasm.
The stimulator may be entirely implanted within the patient's body. The device is controllable in a variety of ways. Current stimulators for pain have the ability to vary according to a 24-hour clock. The device may be equipped with a controller operable by the patient. It is possible to program the device to deliver an arbitrarily limited number of stimulations of predetermined length to prevent overstimulation.
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Spinal Cord Stimulation Percutaneous Lead Implantation Guide; Medtronic, Inc. 1997.
Martin W. Joseph
Meloy T. Stuart
Evanisko George R.
Meloy T. Stuart
Rhodes & Mason P.L.L.C.
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