NeuroGyn’s PosStim™ Pelvic Neurostimulator: The First and Only Permanent Solution Enabling Erection “On Demand”
The Unmet Medical Need
Sexual dysfunctions, including erectile dysfunction, affect both women and men and can be life-long or acquired. ED is one of the most common male sexual health conditions. It impacts men of all ages worldwide. Erectile dysfunction refers to the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. This condition may result from neurological disorders, aging, injuries, or chronic illnesses. ED negatively affects sexual performance and has significant emotional, psychological, and relational consequences. Therefore, optimizing treatment for ED is essential due to its rising prevalence linked to cardiovascular disease, diabetes, pelvic surgeries, and increasing life expectancy.
Challenges with Current ED Treatments
While oral medications like PDE5 inhibitors offer symptom relief, they often fail. This is especially true for patients with neurological damage such as post-prostatectomy, spinal cord injury, or diabetic neuropathy. Current alternatives, such as penile prostheses or intracavernosal injections, remain invasive or poorly accepted, leaving many men without a long-term solution.
A Neurological Problem Demands a Neurological Solution
Parasympathetic fibers initiate erection as a neurovascular process. Sensory feedback from the dorsal penile nerve (DPN), a branch of the pudendal nerve, modulates it. Historical attempts to stimulate these nerves showed potential but faced challenges. These included lack of suitable implantation sites, device miniaturization, and dual-nerve access.
NeuroGyn has solved all these challenges.
The GNS Procedure, patented and developed by Possover, NeuroGyn AG, is the first and only approach that enables permanent, programmable stimulation of both the DPN and cavernous nerves via a single, minimally invasive surgery:
Anatomical advantage: At the penile root, the dorsal penile and cavernous nerves converge, allowing dual-targeting via a small electrode placed just in front of the pubic symphysis, connected with a neuostimulator placed behind and in protection of the pubic bone.
Frequency-tuned stimulation: The cavernous nerve responds to ~60 Hz for initiation of erection (Shafik, Eur Urol, 1994), while the DPN optimizes reflex and maintenance at lower frequencies (~10–20 Hz), creating a physiologically precise and synergistic neuromodulation profile.
Fully internal and aesthetic: The PosStim™ neurostimulator is implanted above or behind the pubic bone, invisible under the skin, and does not interfere with sexual activity or daily life.
Rechargeable, app-controlled, and autonomous: Unlike traditional sacral neuromodulators, PosStim empowers patients to control erection onset and intensity via a secure mobile app enabling “erection on demand” with no need for external programming devices or hospital-based adjustments.
ANATOMICAL INTEGRATION OF CAVERNOSAL NERVES & DORSAL NERVE OF THE PENIS AT THE PENILE ROOT
In the male pelvis, the cavernosal nerves, branches of the inferior hypogastric (pelvic) plexus, carry parasympathetic (and some sympathetic) fibers to the erectile tissues and originate from the sacral plexus (S2–S4) (https://www.elsevier.com/resources/anatomy/nervous-system/peripheral-nervous-system/cavernous-nerves-of-penis left/25149?utm_source=chatgpt.com).
In contrast, the dorsal nerve of the penis (DNP) arises from the pudendal nerve (S2–S4), exits via Alcock’s canal, and runs beneath Buck’s fascia at the penile root, accompanied closely by the deep dorsal vein
(https://www.ncbi.nlm.nih.gov/books/NBK525966/?utm_source=chatgpt.com).
Remarkably, at the penile root, these two nerve systems converge anatomically in close proximity, a relationship that enables simultaneous access during neuro‑stimulation procedures such as GNS (genital nerve stimulation).
Functional Roles & Stimulation Frequencies
- The cavernosal nerves predominantly mediate the induction of erection through parasympathetic-mediated vasodilation and sustain this effect via intracavernosal pressure increases when electrically or magnetically stimulated. One key study reported full erection onset at stimulation frequencies near 60 Hz (Shafik A. Cavernous nerve stimulation through an extrapelvic subpubic approach: role in penile erection. Eur Urol. 1994;26(1):98-102. doi: 10.1159/000475351. PMID: 7925539.)
- The DNP – Dorsal Nerve Penis, by contrast, is mainly somatosensory, conveying afferent signals essential for sexual reflexes and somatic aspects of erection maintenance. Preclinical work, including rat models, has shown that dorsal nerve stimulation modulates bulbospongiosus muscle activity and overall erectile responses (Selcuk Yucel et al. Identification of communicating branches among dorsal, perineal and cavernous nerves of penis. J. Urol. 2003; 170(1):153-8. DOI:1097/01.ju.0000072061.84121.7d)
Studies such as US-Clinical Trial NCT05231083 – GNS for treatment for erectile dysfunctions – Prof. Possover and others using transcutaneous or magnetic stimulation devices suggest that optimal erection outcomes may be achieved by simultaneous or frequency‑selective stimulation of both nerve types
Takeaway
The anatomical proximity of the cavernosal nerves and the DNP at the penile root makes them accessible together during GNS. Each nerve responds best to specific frequency bands, cavernosal nerves for initiation (~60 Hz), and DNP for sensory reflex and maintenance. This dual‑nerve, frequency‑tuned approach is the physiological foundation of the Neurogyn neurostimulator technology.
Stimulation of the dorsal clitoris/penis and cavernosal nerves can help improve genital sensation and sexual arousal and has shown promise in treating erectile dysfunction in men and sexual dysfunction in women.
References
Barrese et al. (2020). Neuromodulation for Erectile Dysfunction: A Review of Current Literature. Journal of Sexual Medicine, 17(5), 899–907.
Wespes et al. (2011). Erectile Dysfunction: European Association of Urology Guidelines European Urology, 59(5), 799–810.
Khunda et al. (2015). Sacral neuromodulation and its relevance to female sexual function: a systematic review. International Urogynecology Journal, 26(3), 321–328.
de Groat et al. (2013). Peripheral afferent nerve pathways mediating bladder reflexes in the cat: evidence for multiple spinal pathways involved in micturition reflexes and sexual function. Journal of Physiology, 591(Pt 18), 4451–4468).
SIMPLICITY & ACCESSIBILITY OF THE GNS PROCEDURE FOR UROLOGISTS
A Paradigm Shift in Neuromodulation for Erectile Dysfunction
The implantation of penile prostheses and other interventions for erectile dysfunction (ED) have traditionally been reserved for highly specialized urologists, requiring advanced surgical skills and technical equipment. However, Genital Nerve Stimulation (GNS) represents a disruptive innovation in the treatment of ED offering a minimally invasive, intuitive, and reproducible procedure that dramatically lowers the technical threshold for effective neuromodulation.
GNS enables direct stimulation of both the dorsal penile nerve and the cavernous nerves using differentiated stimulation frequencies. This dual-target approach mirrors the physiological complexity of erection, addressing both sensory and autonomic components of the erectile response. Crucially, the GNS system is designed to be just as easy to perform as common urological procedures, if not easier. Any trained urologist can adopt the technique without a steep learning curve. A single detailed instructional video suffices to enable accurate and safe reproduction of the procedure. No advanced equipment or programming expertise is needed.
Technical Innovation: Retrograde Electrode Insertion with the Patented Neurogyn Tunneling Applicator System®
The only dedicated tool required for GNS implantation is the patented Neurogyn Tunneling Applicator, specifically developed and clinically validated for urological use. This applicator enables safe and precise tunneling of the electrode system through a small para-penil skin incision less than 1mm, under and in front of the pubic symphysis, with exit through a second small incision less than 1mm at the abdominal wall just above the pubic bone. The tunneling applicator is incerted from below passing behind the pubic bone as in the classical sling-TVT procedure
Once the tunnel is created, the neurostimulator-electrode assembly is inserted retrogradely.
This is a major innovation compared to traditional percutaneous neuromodulation systems (e.g., sacral nerve stimulation), which require intraoperative electrode placement followed by device connection and calibration. With the 2nd passage in front of the pubic bone, the lead electrode is placed in direct contact and parallely to the DNP over 3cm at least.
Key Advantages Over Traditional Neuromodulation and Penile Prostheses
- No intraoperative device connection or testing is necessary. The pre-connected neurostimulator allows complete testing prior to surgery, eliminating technician dependence.
- Patients control stimulation intensity and program selection autonomously via a simple mobile app, empowering them with “erection on demand” capability.
- No technical learning curve for the urologist. Familiarity with standard procedures and anatomy suffices.
- No disruption of penile anatomy, unlike prosthetic implants, and entirely reversible.
GNS not only enhances erectile function but also offers potential benefits in pelvic pain syndromes and bladder dysfunction, making it a versatile addition to the urological toolbox.
By drastically simplifying the implantation process, minimizing technical barriers, and eliminating the need for ongoing technician support, GNS redefines the role of the urologist in neuromodulation: from complex surgical interventionist to autonomous provider of high-precision, patient-controlled therapy.
References:
- Nilsson, C. G., Palva, K., Aarnio, R., Morcos, E., & Falconer, C. (2013). Seventeen years‘ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. International Urogynecology Journal, 24(8), 1265–1269.
- Abdel-Fattah, M., Mostafa, A., & Ramsay, I. (2011). Lower urinary tract injuries after transobturator tape insertion by different routes: A large retrospective study. BJOG, 118(1), 111–116.
- Marcelissen, T. A., et al. (2010). Management of complications associated with the tension-free vaginal tape procedure. Neurourology and Urodynamics, 29(S1), S39–S46.
SCIENTIFIC VALIDATION
The efficacy of genital nerve stimulation (GNS) has been demonstrated in multiple studies for overactive bladder (OAB) and fecal incontinence (van der Aa, Neurourol Urodyn, 2013; Worsøe, Dis Colon Rectum, 2012). Its extension to erectile dysfunction (ED) is strongly supported by decades of foundational research in neuroanatomy and neuromodulation physiology (Yucel, J Urol, 2003; Giuliano, J Physiol, 1993).
Currently, ongoing clinical trials sponsored by NeuroGyn are underway and show highly promising preliminary outcomes. The PosStim neurostimulator will first be introduced in the context of a pivotal study for the treatment of idiopathic overactive bladder (iOAB) in women. Its application in the treatment of neurogenic and refractory ED will follow as part of an extended clinical development pathway (NCT05231083).
Crucially, no other neuromodulation platform offers this unique combination of dual-nerve targeting, pre-assembled implant technology, and outpatient applicability – all in under 10 minutes – with patient autonomy via app-based control.
Key advantages include:
- First-to-marketneuromodulative solution for neurogenic ED
- Scalable, cost-effective, and surgeon-independent: no fluoroscopy, no fixation screws, no specialized personnel required
- Patent-protected method and device, globally relevant across sexual medicine, urology, and gynecology
- Broad therapeutic potentialin bladder, bowel, and pelvic pain disorders, significantly expanding the addressable market
CONCLUSION
NeuroGyn is not merely offering a treatment, it is redefining what’s possible in male sexual health. The PosStim GNS system is the only technology that may restore erection through natural neural pathways, with precision, permanence, and autonomy. With strong IP, clinical validation underway, and unmatched technical simplicity, GNS stands as the next standard of care for ED.
📩 Contact NeuroGyn now or email at m.possover@neurogyn.com to learn more.
