A wearable neuromodulation device (1), configured for insertion into a pelvic orifice of the human body for treating urinary incontinence, faecal incontinence, muscle wastage, spasm and/or spasticity by applying electrical stimulation signals to pudendal nerves through the wall of the rectum or vagina, comprises at least one sensor, such as an electromyographic (EMG) sensor (11) or pressure sensor (12, 13), configured to detect conditions that indicate a requirement for stimulation. The device (1) is autonomous but may be arranged to communicate with an external device (28) comprising an alarm (33), to alert a user to their condition, and/or means (34) for allowing the user to control the stimulation applied by the device. Alternatively, or additionally, the device (1) may communicate with a computer (37) to store patient data for review by a medical professional and/or permit updating of device software. The device (1) may communicate with the external device(s) (28, 37) via wired or wireless links, including Bluetooth or a Body Area Network (BAN). Such a device (1) may comprise an outer sleeve (5) that can be replaced in event of damage, deterioration or discolouration.