Therapeutic devices and methods according to embodiments of the invention alleviate e.g. urinary incontinence in female and male patients. Suction or vacuum, for example, is applied to the genital region, clitoris or clitoral region, the external urethral orifice, and/or other designated areas, e.g. physically stimulating the sacral/pudendal nerves and/or nerve roots and alleviating incontinence. Such embodiments also can encourage or cause clitoral engorgement, or otherwise promote blood flow in the genital region. Vacuum or suction applied to e.g. the clitoris creates a negative pressure in the clitoris that is lower than the systolic blood pressure, tending to promote engorgement of the clitoris with blood. Aspects of the invention are applicable not only to treatment of urinary and fecal incontinence, but also to the treatment of female sexual dysfunction. Aspects of the invention are also applicable to treatment of male incontinence and male erectile dysfunction.