Patent Publication Number: US-2022218979-A1

Title: Neurostimulators to improve male orgasm and systems and methods for use

Description:
RELATED APPLICATION DATA 
     The present application is a continuation of co-pending International Application Serial No. PCT/US2020/053612, filed Sep. 30, 2020, which claims benefit of U.S. provisional application Ser. No. 62/908,502, filed Sep. 30, 2019, the entire disclosures of which are expressly incorporated by reference herein. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to devices, systems, and methods for inducing orgasm in men and, more particularly, to a wearable penile nerve stimulator device for expediting or inducing orgasm and to systems and methods for using such devices. 
     BACKGROUND 
     Delayed orgasm (“DO”), also called delayed ejaculation, anorgasmia, and retarded ejaculation, affects five to ten percent (5-10%) of men leading to anxiety and distress. Individuals suffering from DO generally experience persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation causing personal distress. As a result, afflicted individuals may suffer from decreased self-esteem; feelings of inadequacy, failure, and negativity; anxiety about sex; decreased sexual pleasure; male infertility; low libido; conflicts in relationships, and/or other side effects, potentially leading to the individuals avoiding intimacy with others and/or experiencing difficulties in their personal relationships. 
     Currently no effective solutions exist for many subjects experiencing DO. Subjects may consult their urologist and/or a sex therapist, e.g., to receive one or more of cognitive therapy, physical therapy, medication, and/or other treatments. However, for many subjects, these treatments are ineffective. Implantable nerve stimulators have been suggested, but such stimulators require surgery to implant and remove them. 
     Therefore, devices and methods that facilitate inducing male orgasm would be useful. 
     SUMMARY 
     The present invention is directed to devices, systems, and methods for inducing orgasm in men and, more particularly, to wearable penile nerve stimulator devices for expediting or inducing orgasm and to systems and methods for using such devices, e.g., to improve sexual satisfaction in men experiencing DO. In addition, the devices, systems, and methods herein may be used to treat other conditions, such as premature ejaculation, rehabilitation after pelvic cancer/injury, and the like, or to assist in diagnostic procedures, such as electromyography (“EMG”) and the like, involving the penis. 
     Generally, a wearable penile nerve stimulator is provided, which may target the dorsal genital nerve and/or other nerves or regions of the penis, to expedite and/or improve male orgasm. In an exemplary embodiment, the device may include a reusable component or module including a neurostimulator, a rechargable battery, and a communication unit (e.g., a remote control, mobile phone, tablet, or other electronic device). The reusable module may connect to a disposable band or other wearable component allowing direct skin contact, e.g., targeting of the dorsal penile nerve. The band may be provided in different sizes and may be sufficiently durable to allow for multiple uses before disposal. Alternatively, the neurostimulator module may be permanently integrated into the wearable component or may be separate from the wearable component, e.g., within a remote control that may be connected to the wearable component by one or more cables and/or wirelessly, and the device may be used indefinitely, e.g., with the wearable component cleaned after each use. The wearable component may work on its own or be used with conducting gel/liquid. 
     In accordance with an exemplary embodiment, a device is provided for inducing orgasm that includes a wearable component sized for placement on or around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis, and a neurostimulator module. The neurostimulator module may include a controller coupled to the one or more electrodes for controlling delivery of the electrical stimulae, and a communications interface coupled to the controller for receiving external commands related to delivery of the electrical stimulae. In exemplary embodiments, the wearable component may include one or more rings, straps, bands, a tubular sleeve or body, a clamp, and the like. Optionally, the wearable component and/or module may include one or more sensors for monitoring one or more physical parameters of the user. 
     In accordance with another embodiment, a system is provided for inducing or expediting orgasm that includes a wearable component sized for placement on and/or around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis, and a neurostimulator module. The neurostimulator module may include a controller coupled to the one or more electrodes for controlling delivery of the electrical stimulae, and a communications interface coupled to the controller for receiving external commands related to delivery of the electrical stimulae. The system may also include an electronic device, e.g., a remote control, mobile phone, tablet computer, and the like, including a user interface and a communications interface to allow a user to send commands to the neurostimulator module, e.g., to activate the controller and/or modify the electrical stimulae being delivered. 
     In accordance with still another embodiment, a method is provided for inducing or expediting orgasm that includes placing a wearable device on a penis to position one or more electrodes at a desired region on the penis, and activating a neurostimulator on the wearable device to deliver electrical stimulae to the desired region via the one or more electrodes. 
     In accordance with yet another embodiment, a method is provided for treating a patient after pelvic cancer treatment/pelvic or genital injury that includes placing a wearable device on or adjacent a penis to position one or more electrodes at a desired region relative to the penis; and activating a neurostimulator on the wearable device to deliver electrical stimulae to the desired region via the one or more electrodes to stimulate or rehabilitate penile or pelvic sensory pathways. 
     In accordance with still another embodiment, a method is provided for treating premature ejaculation that includes placing a wearable device on or adjacent a penis to position one or more electrodes at a desired region relative to the penis; and activating a neurostimulator on the wearable device to deliver electrical stimulae to the desired region via the one or more electrodes. 
     In accordance with another embodiment, a device is provided for inducing or expediting orgasm that includes a wearable component sized for placement around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis; and a neurostimulator module comprising a housing removably connectable to the wearable component, a controller coupled to the one or more electrodes when the housing is connected to the wearable component for controlling delivery of the electrical stimulae, and a communications interface coupled to the controller for receiving external commands related to delivery of the electrical stimulae. 
     In accordance with still another embodiment, a device is provided for inducing or expediting orgasm that includes a wearable component sized for placement around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis; and a neurostimulator module comprising a housing permanently mounted to the wearable component, a controller coupled to the one or more electrodes for controlling delivery of the electrical stimulae, and a communications interface coupled to the controller for receiving external commands related to delivery of the electrical stimulae. 
     In accordance with yet another embodiment, a device is provided for inducing or expediting orgasm that includes a wearable component sized for placement around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis; a remote control device comprising a housing separate from the wearable component; and a cable including one or more wires extending between the housing and the wearable component, wherein the remote control comprises a neurostimulator module including a controller coupled to the one or more electrodes via the one or more wires for controlling delivery of the electrical stimulae. 
     In accordance with another embodiment, a system is provided for inducing or expediting orgasm that includes a wearable component sized for placement around a penis, the wearable component including one or more electrodes for delivering electrical stimulae to the penis; and a neurostimulator module including a controller coupled to the one or more electrodes for controlling delivery of the electrical stimulae, and a communications interface coupled to the controller for receiving external commands related to delivery of the electrical stimulae. The system also includes an electronic device comprising a user interface and communications interface to allow a user to send commands to the neurostimulator module, e.g., wirelessly or via a cable connected to the neurostimulator module. 
     Other aspects and features of the present invention will become apparent from consideration of the following description taken in conjunction with the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention is best understood from the following detailed description when read in conjunction with the accompanying drawings. It is emphasized that, according to common practice, the various features and design elements of the drawings are not to-scale. On the contrary, the dimensions of the various features and design elements are arbitrarily expanded or reduced for clarity. Included in the drawings are the following figures: 
         FIGS. 1A and 1B  are perspective views of an exemplary embodiment of a wearable neurostimulator device including a ring including a pair of electrodes and a neurostimulator module connected the ring and electrodes. 
         FIG. 1C  is a schematic showing exemplary components that may be included in the neurostimulator module of the wearable device of  FIGS. 1A and 1B . 
         FIGS. 2A and 2B  are cross-sectional views of male genitals showing the wearable neurostimulator device of  FIGS. 1A and 1B  worn on the penis. 
         FIGS. 3A-3F  show examples of alternative embodiments of wearable components that may be included in a neurostimulator device. 
         FIGS. 4A-4C  show examples of neurostimulator devices that include a remote control separate from a wearable component. 
     
    
    
     DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS 
     Before the exemplary embodiments are described, it is to be understood that the invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims. 
     Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limits of that range is also specifically disclosed. Each smaller range between any stated value or intervening value in a stated range and any other stated or intervening value in that stated range is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included or excluded in the range, and each range where either, neither or both limits are included in the smaller ranges is also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention. 
     Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, some potential and exemplary methods and materials are now described. 
     It must be noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to “a compound” includes a plurality of such compounds and reference to “the polymer” includes reference to one or more polymers and equivalents thereof known to those skilled in the art, and so forth. 
     Turning to the drawings,  FIGS. 1A-1C  show an exemplary embodiment of a device  10  for inducing orgasm in men that generally includes a wearable ring or band  12  sized for placement around a penis  90  (not shown, see  FIG. 2A ) and a neurostimulator or control module  20 . The ring  12  may carry one or more electrodes or other conductive pads, e.g., a pair of pads  14  as shown located on an inner surface  12   a  of the ring  12 . Optionally, the ring  12  may be provided in a range of sizes such that an individual user may use a ring of an appropriate size for their penis. 
     In exemplary embodiments, the ring  12  may be formed from flexible biocompatible materials to increase comfort during use, e.g., to facilitate placement and removal. For example, the ring  12  may be formed from an enclosed band of silicone or other elastomeric or polymeric materials that may be sufficiently elastic to stretch slightly to accommodate placement and removal and/or to adjust in size when the penis  90  is stimulated. Alternatively, the ring  12  may be formed from inelastic material, e.g., PVC and/or other plastic or non-electrically conductive materials, having a fixed diameter or other shape, e.g., between about 20-50 mm, between about 20-30 mm, between about 30-40 mm, or between about 40-50 mm. As shown in  FIGS. 1A and 1B , the ring  12  is an enclosed loop having a width “W,” e.g., between about 5-30 mm, defining an inner surface  12   a , an outer surface  12   b , and opposing annular side edges  12   c.    
     Alternatively, a ring may be provided that is not completely enclosed. For example,  FIG. 3A  shows an example of a neurostimulator device  110   a  that includes a ring  112   a  and control module  120   a  coupled to electrodes  114   a , generally similar to the previous embodiments. In this case, however, the ring  112   a  has a “C” shaped cross-section that includes ends  115   a  that may be spaced apart one another and/or that may partially overlap in a relaxed state. Optionally, in this alternative, the ends  115   a  may be rounded or otherwise shaped to minimize discomfort when the ring is worn. In addition, such a “C” shaped ring  112   a  may be elastic, e.g., biased to a relaxed diameter or state, yet radially expandable, may be inelastic, e.g., set at a fixed diameter, or may be malleable, e.g., such that the ends  115   a  may be forced apart to increase the diameter and/or overlapped or otherwise directed to towards one another to reduce the diameter, e.g., to wrap the ring  112   a  at least partially around a penis  90  (shown in phantom). 
     In another alternative, shown in  FIG. 3B , a device  110   b  may be provided that includes a plurality of rings  112   b , each having a “C” shaped (or circular, not shown) cross-section, that are spaced apart from one another along a central longitudinal axis  117   b . The rings  112   b  may be permanently connected together by one or more axial supports  118   b  (one shown) to maintain their spacing. Each of the rings  112   b  may include one or more electrodes, e.g., two electrodes  114   b  adjacent one another for delivering stimulae to the underlying dorsal nerves (not shown) or a plurality of electrodes around the inner surface, similar to other embodiments herein. The support(s)  118   b  may include one or more wires or other leads (not shown), e.g., embedded within the support(s)  118   b  to couple the electrodes  114   b  to the neurostimulator module  120   b , e.g., for delivering stimulae simultaneously, sequentially, and/or in other patterns, as described elsewhere herein. The support(s)  118   b  may be flexible, rigid, or malleable, similar to other embodiments herein. In addition, the rings  112   b  may be elastic, as described above, or may be malleable, e.g., such the rings  112   b  may be opened, positioned around the penis  90 , and then deformed to clamp or otherwise secure the rings  112   b  around the penis  90 . 
     In yet another alternative, shown in  FIG. 3C , a neurostimulator device  110   c  may be provided that includes a helical ring  112   c  that spirals one or more times around a central axis  117   c  between opposite ends  115   c  of the ring  112   b , which may also be elastic, inelastic, or malleable, similar to the previous embodiments. In this alternative, a plurality of electrodes  114   b  may be provided, as desired, spaced apart from one another around the circumference and/or along the length of the helical ring  112   b , e.g., a pair of electrodes adjacent one another on the same side of each loop for delivering stimulae to the underlying dorsal nerves (not shown), or spaced apart evenly or otherwise around the inner surface between the ends  115   c.    
     In still another alternative, shown in  FIG. 3D , a neurostimulator device  110   d  may be provided that includes one or more longitudinal bands  112   d  that are connected together by one or more annular or “C” shaped supports  118   d , e.g., to space the bands  112   d  around central axis  117   d . For example, with two bands  112   d , as shown, the bands  112   d  may be attached to the supports  118   d  opposite one another for placement on opposite sides of a penis  90 . Each band  112   d  may include one or more electrodes, e.g., a plurality of electrodes  114   d  spaced apart from one another at least partially along the length of the band  112   d . One or more leads (not shown) in the bands  112   d  and/or supports  118   d  couple the electrodes  114   d  to the neurostimulator module  120   d  for delivering the electrical stimulae. 
     In additional alternatives, shown in  FIGS. 3E and 3F , a neurostimulator device  110   e ,  110   f  may be provided that includes one or more electrodes  114   e ,  114   f  on a tubular sleeve  112   e ,  112   f , e.g., formed from elastic or inelastic material such as those described above. For example, as shown in  FIG. 3E , the sleeve  112   e  may include open ends  115   e  or, as shown in  FIG. 3F , the sleeve  112   f  may include an open end  115   f ( 1 ) and a closed end  115   f ( 2 ), e.g., configured similar to a condom (not shown), that may be positioned over the penis  90  such that the electrode(s)  114   e ,  114   f  are located at desired locations. Optionally, as shown in  FIG. 3F , the sleeve  112   f  may include an annular collar  119   f  on the open end  115   f ( 1 ), e.g., to facilitate sliding the sleeve  112   f  into place. Alternatively, a sleeve may be formed as a sheet (not shown) that may be rolled around the penis and longitudinal edges of the sheet may be removably attached together to secure the sleeve, e.g., using low tack adhesive, hook and eye fasteners, elastic, self-cinching/friction, and the like. In still another alternative, a mesh or net structure may be provided, e.g., having a tubular shape (not shown), that may be positioned over the penis. In a further alternative, one or more electrodes may be provided on an adhesive strip, band, or patch (also not shown), which may be removably adhered to a desired location on or adjacent the user&#39;s penis. In these alternatives, electrodes may be spaced apart from one another as desired, e.g., around a circumference and/or along a length of the wearable component. 
     Returning to  FIGS. 1A and 1B , the electrodes or pads  14  may be formed from biocompatible, conductive material, e.g., formed to be flush with the inner surface  12   a  of the ring  12  (or other wearable component, as described elsewhere herein) and/or otherwise shaped and/or mounted to the ring  12  to maximize comfort for the user using the device  10  while ensuring the electrodes  14  contact the user&#39;s skin. For example, the electrodes  14  may be molded into the material of the ring  12 , may be permanently attached to the inner surface  12   a , e.g., by one or more of bonding with adhesive, fusing, heat sealing, inserting into recesses, and the like. The ring  12  may include one or more leads  16  communicating with the electrodes  14 , e.g., embedded within the ring  12  to deliver electrical signals to the electrodes  14  from the neurostimulator module  20 . 
     Optionally, the ring  12  (or other wearable components herein) may include one or more visual markers (not shown), e.g., positioned at one or more locations on the outer surface  12   b , side edges  12   c , and/or otherwise around the circumference of the ring  12 , which may facilitate the user orienting the ring  12  to position the electrodes  14  adjacent a desired target region. For example, as shown in  FIG. 2B , a pair of electrodes  14  are provided immediately adjacent one another for stimulating the dorsal nerves  92  of the penis  90  and the ring  12  may include a marker (not shown) on the outer surface opposite the electrodes such that the user may orient the marker anteriorly to position the electrodes  14  adjacent the dorsal nerves. Alternatively, a plurality of electrodes may be provided on the ring  12  that are distributed around the circumference of the inner surface  12   a , e.g., in one or more rows or other patterns spaced substantially uniformly apart from one another (not shown), to deliver the electrical stimulae uniformly to the underlying region. 
     The neurostimulator module  20  may be removably mountable to the ring  12  (or the other wearable components described herein), e.g., such that the neurostimulator module  20  may be reusable when the ring  12  wears or deteriorates and must be replaced. For example, as shown in  FIG. 1C , the neurostimulator  20  module may include an external housing  22  containing and/or protecting the internal components, e.g., a controller or neurostimulator  24 , a battery or other power source  26 , and a communications interface  28 . The housing  22  may provide a fluid-tight package, e.g., such that the neurostimulator module  20  and/or entire device  10  may be cleaned after use, as desired, without damaging circuits of the module  20 . 
     Optionally, the ring  12  (or other wearable component) and/or neurostimulator module  20  may include one or more additional components. For example, one or more accelerometers or other motion sensors (not shown) may be provided in the housing  22  that are coupled to the controller  24  for detecting motion of the user, e.g., as described elsewhere herein. In addition or alternatively, memory (not shown) may be provided within the housing  22  for storing control parameters and/or data from the controller  24  related to use of the device  10 . In another option, an inductive charger (not shown) may be provided in the housing  22  that is coupled to the battery  26  for wirelessly recharging the battery  26 , or a connector (also not shown) may be provided on the housing  22  for receiving a cable that may be connected to an external charging device (also not shown). 
     Optionally, one or more pressure sensors may be provided on the ring  12  that may be coupled to the controller  24  when the module  20  is attached to the ring  12 , e.g., to measure dilation forces applied to the ring  12  by the user&#39;s penis, measure rigidity of the penis, and/or to measure contact pressure between the user and their partner&#39;s body. In another option, a pulse oximetry or other sensor may be provided on the ring  12  (also coupled to the controller  24 ), e.g., to measure pulse rate, oxygen levels, and/or other parameters of the user. As described elsewhere herein, signals from these sensors may be monitored and/or analyzed by the controller  24  during use, e.g., to monitor the user&#39;s response and/or to change parameters of stimulation during use. 
     In addition, as shown in  FIG. 1C , the ring  12  and housing  22  may include one or more cooperating connectors  13 ,  23  to allow the neurostimulator module  20  to be removably attached to the ring  12 , e.g., using one or more detents, snaps, adhesives, hook and eye fasteners, and the like (not shown). Thus, a ring  12  may be used multiple times with the neurostimulator module  20  and, after a predetermined or desired number of uses, the ring  12  may be replaced and the neurostimulator module  20  connected to the new ring for further use. In addition, the connectors  13 ,  23  may allow the neurostimulator module  20  to be removed for recharging when not in use. Alternatively, the neurostimulator module (or individual components thereof) may be permanently integrated into the ring  12 , e.g., by bonding with adhesive, fusing, heat sealing, and the like, and the entire device  10  may be replaced when warranted. In this alternative, the material of the ring  12  (or other wearable component) may be sufficiently durable to last for the life of the device  10 , e.g., without substantial wear during use, cleaning, and the like. 
     In another alternative, the neurostimulator module may be provided separate from the wearable component and connected to the electrode(s) (and any other optional components provided on the ring) via one or more wires or using remote signaling. For example, as shown in  FIGS. 4A-4C , the neurostimulator module may be a separate remote control unit  220 , which may be held by the user or worn, e.g., on the user&#39;s belt, underwear, and/or other article of clothing, e.g., secured by a clip or other connector (not shown). In this alternative, the control unit  220  may be recharged between uses, e.g., using inductive charging or by connecting a charging cable (not shown) to the control unit  220 . 
     For example, as shown in  FIG. 4A , a device  210  is shown that includes a wearable component  212  (which may be any of the embodiments herein) including one or more electrodes  214   a  contacting the penis  90  when attached to the penis  90 . The control unit  210  may be placed against the user&#39;s skin, e.g., immediately above or otherwise near the penis  90 , and secured, e.g., using low tack adhesive, one or more straps (not shown), and the like. In this alternative, a cable  216   a  including one or more wires (not shown) may extend from the control unit  210  to the wearable component  212 . Ends of the cable  216   a  may be permanently attached to one or both of the control unit  220  and the wearable unit  212  (and coupled to the electrode(s)  214   a  by one or more leads on the wearable unit  212 ) or a connector may be provided on one or both such that the cable  216  may be disconnected when the device  210  is not in use. Optionally, as shown, the device  210  may include a second set of electrodes  224   a  (including one or more electrodes) on the control unit  220  that contact the user&#39;s skin when the control unit  220  is secured. Thus, in this alternative, the neurostimulator module  220  may include an adhesive patch or other feature for removable fixing the neurostimulator module to the user&#39;s body, e.g., remote from the user&#39;s penis  90 , with one or more wires  216   a  extending to the wearable component to deliver the desired electrical stimulation or via a wireless stimulation. 
     In a further alternative device  210   b , shown in  FIG. 4B , instead of an adhesive patch, the neurostimulator module  220  may be carried on a belt  240  that may be secured around the user&#39;s torso. In this alternative, one or more wires  242  may be provided in the belt  240  that are coupled to cable  216   b  that is coupled, in turn, to the electrode(s)  214  on the wearable component  212 .  FIG. 4C  shows another alternative device  210   c  in which the neurostimulator module  220  may be carried on a garter belt  244  or similar support that may be secured around the user&#39;s leg  96 . Either belt  240 ,  244  may include one or more straps and/or connectors for securing ends of the straps together, e.g., using one or more of buckles, hook and eye fasteners, and the like (not shown), to allow the belt  240 ,  244  to be tightened and/or otherwise secured to the user&#39;s body before use and then removed after use. The neurostimulator module  220  may be received in a pocket (not shown) and/or otherwise removably secured to the belt  240 ,  244  or permanently attached to the belt  240 ,  244 , as desired. 
     Optionally, the devices  210   b ,  210   c  includes a second electrode (or set of electrodes)  224   b ,  224   c  that are connected to cable  216   b ,  216   c  such that the second electrode(s)  224   b ,  224   c  may be placed at a desired location on the user&#39;s body, e.g., above the penis  90 , as shown in  FIG. 4B , or to the perineum behind the scrotum  94 , as shown in  FIG. 4C . The second electrode(s)  224   b ,  224   c  may be attached to the user&#39;s skin, e.g., using a low tack adhesive or other feature allowing removal after use. 
     With reference to the device  10  shown  FIGS. 1A-1C  (although applicable to all of the embodiments described herein), the controller  24  may be coupled to the one or more electrodes  14 , e.g., via one or more leads  16 , for controlling delivery of electrical signals to the electrodes  14  to stimulate a desired region of the user&#39;s penis. In an exemplary embodiment, the controller  24  may be configured to deliver relatively low frequency electrical pulses to the penis, e.g., at a frequency between about three and twenty Hertz (3-20 Hz). In further exemplary embodiments, the pulses may have pulse widths between about fifty and two hundred microseconds (50-200 μs), amplitudes between about one and fifty milliamps (1-50 mA), and/or voltages between about one and twenty five Volts (1-25 V). The pulses may have substantially uniform parameters, e.g., within these exemplary ranges, or the parameters may be varied, e.g., varying the pulse widths and/or varying the strength (e.g., amplitudes) in a cyclical or other desired pattern to enhance stimulation, as described elsewhere herein. In an exemplary embodiment, the device  10  may deliver a sinusoidal or other crescendo/decrescendo cyclical pattern having desired durations, e.g., between about two and sixty second (2-60 sec) durations. The cyclical patterns may be continuous once the device  10  is activated or the patterns may be separated by gaps having desired durations. In addition or alternatively, the patterns may be modified by the controller  24  based on one or more factors, e.g., feedback from sensors of the device  10 , instructions from a remote control unit or electronic device, and the like, as described further elsewhere herein. Optionally, the pulses may be delivered in a bipolar or monopolar configuration between the electrodes. 
     The communications interface  28  may be coupled to and/or otherwise communicate with the controller  24  for receiving external commands related to delivery of the electrical stimulae. For example, a wireless radiofrequency interface may be provided for receiving wireless signals, e.g., using Bluetooth or other radiofrequency communications protocols, including commands related to delivery of the electrical stimulae. The command may simply include an activation command, whereupon the controller  24  may deliver a preset pattern or sequence of electrical stimulate and then discontinue delivery and wait for further instructions, or the commands may include activation/deactivation instructions. Alternatively, the commands may include instructions regarding the parameters of the pulses and/or repeating pulse delivery one or more times, e.g., parameters selected by the user, modified parameters based on feedback from sensor(s) on the device  10 , and the like, as described further elsewhere herein. 
     In an exemplary embodiment, as shown in  FIG. 2A , the interface  28  may allow the device  10  to communicate with a remote electronic device  30 , e.g., a dedicated remote control unit, the user&#39;s mobile phone, tablet computer, and the like, which may include a user interface  32  (e.g., including one or more of a display, touchscreen, keyboard, and the like) and a communication interface (not shown), e.g., using Bluetooth or other wireless protocols, as represented by signals  34 . For example, a software application may be provided that may be loaded into memory of the electronic device  30  to allow the user to deliver commands to the neurostimulator module  20 , e.g., to simply activate/deactivate the device  10  and/or to select preset or custom patterns or sequences of electrical stimulae. 
     During use, as shown in  FIG. 1 , the ring  12  (or other wearable component described herein) may be placed on the user&#39;s penis  90  to position one or more electrodes  14  at a desired region on the penis  90 . For example, as shown in  FIGS. 2A and 2B  the user may position the ring  12  at the base of the penis  90 , e.g., to deliver electrical stimulae to the paired dorsal nerves  92 , to the dorsal/ventral phallus, and/or to the lateral phallus. Optionally, a conductive gel or other liquid may be applied, e.g., directly to the penis  90  and/or to the inner surface  12   a  of the ring  12 , to enhance electrical coupling between the electrodes  14  and the user&#39;s skin. 
     Optionally, one or more additional electrodes may be provided that are coupled to the device  10  that may be attached to other regions of the user&#39;s body. For example, one or more electrodes may be attached to the user&#39;s perineum, scrotum, abdomen, pelvis, and/or other locations, as shown and described with reference to  FIGS. 4A-4C . Alternatively, a separate device including electrodes and a neurostimulator (not shown) may be provided that may be secured to the perineum or other region to deliver stimulation to the perineum or other region of the user&#39;s body. 
     Once the ring  12  (or other wearable component described herein) is properly positioned, the neurostimulator module  20  may be activated to deliver electrical stimulae to the desired region via the one or more electrodes  14  in a desired manner, e.g., as described elsewhere herein. 
     For example, it will be appreciated that the device  10  may be used to deliver electrical stimulae to induce and/or expedite orgasm in a variety of ways. For example, the device  10  may be placed on the user&#39;s penis  90  and used to deliver electrical stimulae during sexual stimulation, e.g., intercourse or other sexual activity. Alternatively, the device  10  may be used prior to sexual stimulation, e.g., anywhere from five minutes to twenty four hours before sexual activity, e.g., with the device  10  delivering various sequences of electrical stimulae. In another alternative, the device  10  may be used daily and/or at other periodic intervals that are not related to the user&#39;s sexual activity. Usage time during any particular session may be the same or variable depending on the user&#39;s preferences, e.g., between about three and thirty minutes per session. 
     With additional reference to  FIG. 2A , the wearable device  10  (or any of the devices described herein) may be included in a system  8 , e.g., including a dedicated remote control or other electronic device  30 , e.g., a mobile phone, tablet, and the like, that may communicate with the device  10  remotely to assist the user in inducing or expediting orgasm. For example, the user may install a software application on their existing electronic device  30  that may allow the user to control the neurostimulator module  20  during use. Optionally, the application may allow the electronic device  30  to receive data from the neurostimulator module  20 , e.g., to allow the user or a medical or other professional to monitor response of the user and/or adjust parameters of the neurostimulator module  20 . 
     Alternatively, the device  10  may include a dedicated remote control including a user interface and electronics dedicated to operation of the device  10 . The remote control may be a simple device, e.g., including a switch that the user may actuate to turn the device  10  on and off, e.g., with the controller  24  delivering electrical stimulae immediately upon activation of the device  10 . Alternatively, the remote control may provide a more sophisticated user interface to allow the user to send instructions to the neurostimulator module  20 . 
     In an exemplary embodiment, the controller  24  may be preprogrammed with one or more stimulae parameters or patterns that may be used initially to deliver electrical stimulae to the penis  90 . After using different available patterns, the user may provide feedback, e.g., via the user interface  32  of the electronic device  30  (or remote control). The processor (not shown) of the electronic device  30  (or a server or other system communicating with the electronic device  30 ) may modify parameters or patterns based on the feedback and send instructions to the controller  24  of the neuro stimulator module  20  to modify parameters for future electrical stimulae accordingly. Optionally, a menu of available parameters may be presented on the user interface  32  of the electronic device  30  and the user may select desired parameters before or during use and corresponding instructions may be communicated to the controller  24 . 
     Optionally, if the device  10  includes one or more sensors, the controller  24  may process signals from the sensors to monitor one or more parameters of the user, and modify patterns of the electrical stimulae based at least in part on the signals. Alternatively, the controller  24  may communicate the signals and/or parameters to the electronic device  30  for processing and/or determining how to modify the patterns used by the controller  24 . For example, if a motion sensor is provided on the device  10 , the controller  24  (or electronic device  30 ) may modify the pattern of electrical stimulae when motion is detected, e.g., rapid or cyclical motion, which may indicate sexual activity, whereupon the intensity of the electrical stimulae may be increased, e.g., to induce or expedite orgasm. In addition or alternatively, other parameters of the user may be monitored, e.g., pulse rate, oxygen concentration, pressure, and the like, which may be used in a similar manner to modify patterns and/or intensity of the electrical stimulae. Optionally, the controller  24  (and/or the electronic device  30 ) may suggest adjustments to the patterns of stimulae and communicate them to the electronic device  30  for presentation and/or selection by the user. Optionally, via communications with a central server, settings and/or feedback with multiple users may be compiled and/or analyzed, e.g., using a machine learning platform that may optimize device settings based on patient preferences/sensory inputs. 
     In another option, the controller  24  may use the electrodes  14  to detect one or more physical parameters of the user. For example, the controller  24  may receive signals from the electrodes  14  corresponding to muscular contraction, motion, and the like, which may be processed by the controller  24  or communicated to the electronic device  30  for processing, e.g., for diagnostic or other purposes. 
     Optionally, the application on the electronic device  30  (or dedicated remote control) may provide a training program to identify and/or assist the user in selecting stimulation treatments that may condition the user for quicker orgasm, e.g., for future use with or without the device  10 . 
     While the devices, systems, and methods described herein have been described with reference to expediting or inducing orgasm, e.g., in subjects experiencing delayed orgasm, the devices, systems, and methods herein may be used to treat other conditions, such as premature ejaculation, rehabilitation after pelvic cancer/injury, and the like, or to assist in diagnostic procedures, such as electromyography (“EMG”) and the like, involving the penis. For example, after a patient undergoes pelvic cancer treatment (e.g. surgery or radiation), the devices and systems herein may be used to stimulate and/or rehabilitate penile (and or pelvic) sensory pathways. 
     While the invention is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular forms or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents and alternatives falling within the scope of the appended claims.