Stimulation of the urinary system
Apparatus and methods are provided, including a bladder stimulator that includes an elongate element adapted to pass through a urethra or adapted to pass through another opening in the bladder, an expandable body coupled to said elongate element, and an array of one or more stimulator contacts coupled to the expandable body, the array including at least one contact adapted to contact a portion of a bladder of a subject when the expandable body is inserted in the bladder and expanded. A controller stimulates the portion of the bladder by driving a pulse into the bladder via the contact, the pulse having a frequency of 5 Hz-1 kHz. Other applications are also described.
1. A method of controlling a physiological state of a subject, comprising:
(a) determining that it is desired to affect functioning of a system of the subject, the functioning being selected from the group consisting of: renal functioning, and cardiovascular functioning; and
(b) in response thereto, affecting the selected functioning in the desired manner, by electrically stimulating a urine carrying portion of a urinary system of the subject selected from the group consisting of: a ureter, a trigone, a uretero-vesical junction, a urethra, a renal pelvis, an internal structure of the kidney, a lumen in the kidney, and a bladder,
the electrical stimulation of the selected portion causing a therapeutic change in a value of at least one parameter, relative to a value of the parameter in an absence of the electrical stimulation being applied to the selected portion, the parameter being selected from the group consisting of: glomerular filtration rate, renal blood flow, diuresis, and natriuresis.
2. The method according to claim 1 , wherein said stimulating comprises modulating a gain of a sympathetic drive to the kidney.
3. The method according to claim 1 , wherein said stimulating comprises modulating activity of an afferent nerve innervating the urinary system.
4. The method according to claim 1 , wherein said stimulating comprises affecting the selected functioning by performing an action selected from the group consisting of: activating and modulating, with respect to at least one nervous reflex.
5. The method according to claim 1 , further comprising administering systemic medication to the subject, the stimulating being configured to interact with the administration of the medication to the subject.
6. The method according to claim 1 , wherein said stimulating comprises causing an increase by at least a factor of 1.1 in one or more of the parameters.
7. The method according to claim 1 , wherein said stimulating comprises stimulating one or more portions of the subject's body selected from the group consisting of: a ureter, a trigone, a uretero-vesical junction, and a bladder.
8. The method according to claim 1 , wherein said stimulating comprises stimulating via a stimulator that remains in the subject's body for three days to two weeks.
9. The method according to claim 1 , wherein said stimulating comprises stimulating via a stimulator that is implanted in the subject's body for at least two weeks.
10. The method according to claim 1 , wherein said stimulating comprises treating at least partially one or more conditions selected from the group consisting of: acute heart failure, congestive heart failure, hypertension, acute renal failure, contrast nephropathy, chronic renal failure, shock, septic shock, nephrotic syndrome, cardio-renal syndrome and myocardial infarct.
11. The method according to claim 1 , wherein said stimulating comprises stimulating for at least 2 hours a day.
12. The method according to claim 1 , wherein said stimulating comprises stimulating in such a manner that the selected functioning is affected for at least 30 minutes after stimulation is stopped.
13. The method according to claim 1 , further comprising receiving an input during the stimulation, and modifying a parameter of the stimulation in response thereto.
14. The apparatus according to claim 13 , further comprising determining a physiological parameter of the subject during the stimulation, wherein receiving the input comprises receiving an input that is indicative of the physiological parameter of the subject.
15. The method according to claim 14 , wherein determining the physiological parameter comprises determining urine flow of the subject during the stimulation, and wherein modifying the parameter of the stimulation comprises modifying the parameter of the stimulation in response to the determined urine flow.