Pudendal Nerve Burst Stimulation for Bladder Control

1 . An apparatus for stimulating neural activity in a pudendal nerve of a subject, the apparatus comprising:

at least one primary electrode configured to apply a first electrical signal to said pudendal nerve; and

a controller coupled to said primary electrode(s) and controlling the first electrical signal to be applied thereby, wherein said controller is configured to cause said at least one primary electrode to apply said first electrical signal that stimulates neural activity in the pudendal nerve to improve bladder function, wherein the first electrical signal comprises an AC waveform having a frequency in a range of from 0.1-100 Hz and wherein the first electrical signal is applied in a burst pattern.

2 .- 4 . (canceled)

5 . The apparatus according to claim 1 in which the first electrical signal has an amplitude in the range of from 0.1-20 mA.

6 . The apparatus according to claim 1 wherein the burst pattern of the first electrical signal comprises a signal burst having a duration in a range of from 20 ms to 2000 ms.

7 . (canceled)

8 . The apparatus according to claim 6 in which the burst pattern comprises a signal burst repeated at an interval of from 0.1 s to 2 s.

9 .- 16 . (canceled)

17 . The apparatus according to claim 1 in which the first electrical signal is to be applied to a sensory branch of the pudendal nerve.

18 .- 19 . (canceled)

20 . The apparatus according to claim 1 wherein the first electrical signal is to be applied to the pudendal nerve or sacral root.

21 .- 22 . (canceled)

23 . The apparatus according to claim 1 , wherein the apparatus further comprises at least one secondary electrode configured to apply a second electrical signal to a compound pudendal nerve, a sacral root, or a pudendal motor nerve; and a controller coupled to said secondary electrode(s) and controlling the second electrical signal to be applied thereby, wherein said controller is configured to cause said at least one secondary electrode to apply said second electrical signal that stimulates neural activity in the compound pudendal nerve, sacral root, or pudendal motor nerve to improve voiding efficiency, wherein the second electrical signal comprises an AC waveform having a frequency in a range of from 0.1-100 Hz and wherein the second electrical signal is applied in a burst pattern, optionally wherein an improvement in voiding efficiency is an increase in voiding efficiency.

24 .- 41 . (canceled)

42 . A method of treating bladder dysfunction in a subject comprising:

i. implanting in the subject an apparatus according to claim 1 ;

ii. positioning at least one primary electrode of the apparatus in signalling contact with a pudendal nerve of the subject; and

iii. activating the apparatus to apply an electrical signal to the pudendal nerve of the subject as caused by the controller.

43 . (canceled)

44 . A method of treating bladder dysfunction in a subject comprising applying a first electrical signal to a pudendal nerve of the subject to stimulate activity in said pudendal nerve, wherein the first electrical signal comprises an AC waveform having a frequency in a range of from 0.1-100 Hz and wherein the first electrical signal is applied in a burst pattern.

45 .- 48 . (canceled)

49 . A method according to claim 44 in which the first electrical signal has an amplitude in a range of from 0.1-20 mA.

50 . A method according to claim 44 wherein the burst pattern of the first electrical signal comprises a signal burst having a duration in a range of from 20 ms to 2000 ms.

51 . (canceled)

52 . A method according to claim 44 in which the burst pattern comprises a signal burst repeated at an interval of from 0.1 s to 2 s.

53 .- 60 . (canceled)

61 . A method according to claim 44 in which the first electrical signal is applied to a sensory branch of the pudendal nerve.

62 . A method according to claim 44 in which the first electrical signal is applied to sensory fibres or a sensory branch of the pudendal nerve and stimulates neural activity in the sensory branch of the pudendal nerve to produce an increase in bladder capacity and/or a decrease in unwanted urine output.

63 . (canceled)

64 . A method according to claim 44 wherein the first electrical signal is to be applied to the pudendal nerve or sacral root.

65 .- 84 . (canceled)

85 . A method according to claim 44 further comprising detecting one or more physiological parameters in the subject to determine an ongoing phase of a micturition cycle in the subject, optionally wherein the one or more physiological parameters are selected from: nerve activity in the pudendal nerve, nerve activity in a hypogastric nerve, nerve activity in a pelvic nerve, muscle activity in a bladder detrusor muscle, muscle activity in an internal urethral sphincter, muscle activity in an external urethral sphincter, muscle activity in an external anal sphincter, and bladder pressure.

86 . (canceled)

87 . A method according to claim 44 wherein the first electrical signal is applied on receiving an input from the subject that the subject wishes to delay onset of a voiding phase.

88 . A method according to claim 44 wherein the first electrical signal is applied on receiving an input from the subject indicating that the subject has sensed a urinary leak.

89 . A method according to claim 44 wherein the first electrical signal is applied on receiving an input from the subject that the subject wishes to increase voiding efficiency.

90 .- 92 . (canceled)

93 . A neuromodulation system comprising a plurality of apparatuses according to claim 1 .