Methods, systems and devices for determining optimal placement for pudendal nerve stimulation lead using patient feedback

摘要

The present disclosure involves a method of measuring a physiological feedback from a patient in response to electrical stimulation. A stimulation parameter of a sacral nerve stimulation therapy is ramped up. The sacral nerve stimulation therapy includes electrical pulses generated by a pulse generator based on programming instructions received from an electronic programmer. The electrical pulses are delivered to a patient via a stimulation lead that is implanted in the patient. Via an anal electrode device that is at least partially inserted inside an anal canal of the patient, a compound motor action potential (CMAP) is measured from an anal sphincter of the patient while the stimulation parameter of the sacral nerve stimulation therapy is being ramped up. A stimulation threshold is determined based on the measured CMAP.

主权项

1. A medical system of measuring a physiological feedback from a patient in response to electrical stimulation, comprising:
an anal electrode device that is configured to be inserted into an anal canal of a patient, wherein the anal electrode device is configured to measure a compound motor action potential (CMAP) from an anal sphincter of the patient while a sacral nerve stimulation therapy is delivered to the patient; a stimulation lead having a plurality of electrode contacts, wherein the stimulation lead is implantable inside the patient; a pulse generator electrically coupled to the stimulation lead, wherein the pulse generator is configured to generate electrical pulses of the sacral nerve stimulation therapy to be delivered by one or more of the electrode contacts to the patient; and an electronic programmer telecommunicatively coupled to the pulse generator, wherein the electronic programmer is configured to program the pulse generator to generate the electrical pulses, and wherein the electronic programmer is configured to:
ramp up a stimulation parameter of the sacral nerve stimulation therapy;receive measurements of the CMAP as the stimulation parameter of the sacral nerve stimulation therapy is being ramped up; anddetermine a stimulation threshold based on the received measurements of the CMAP.