Over the several years which I have been conducting pelvic floor muscle rehabilitation, I have noticed that most women enter my office for the first visit with some degree of anxiety and uncertainty. This is quite understandable considering the uncertainty about what is going to happen during the evaluation. I thought, therefore, it would be useful for patients undergoing the Glazer Protocol, to know exactly what will happen during their office visits.
First of all, patients are informed that they are welcome to be accompanied to their session by their spouse or other significant person. This person can be present to observe the entire evaluation. I strongly encourage the presence of a spouse or significant other particularly during the initial evaluation process. After the collection of basic identifying and demographic information, I conduct a review of the patients personal and familial medical history, as well as a detailed history of the vulvovaginal pain conditions. A further review of all diagnostic procedures and treatments which the patient has undergone are noted. Finally a detailed sexual and psychological history are conducted and discussion of the impact of the symptoms on present psychological and sexual functioning is conducted.
The patient is then provided with a detailed explanation of the procedure including discussion of anatomy, physiology and function of the muscles of the pelvic floor. The patient is given an understanding of the relationship between pelvic floor muscle dysfunction and the vulvovaginal pain they experience. The technology of electromyography is explained and patients are shown normal muscle readings against which they can compare their own readings.
The patient is then given the intravaginal sensor (a tampon-like device) with instructions for its use. Patients then PRIVATELY insert the sensor and return to the examining room fully clothed. The wire leading from the sensor is then plugged into the computerized surface electromyograph for the evaluation. Throughout the course of the evaluation the patient is able to literally see the activity of their pelvic floor muscles. After some brief instructions regarding correct use of the muscle the patient undergoes the Glazer Protocol. The protocol consists of voluntary muscle contractions, with rest periods intervening. The entire muscle evaluation process takes approximately 6 minutes. The procedure is PAINLESS.
Once the evaluation report has been printed out, I review it with the patient and identify any abnormal findings. A determination is made during the first evaluation if pelvic floor muscle dysfunction exists and if it is a likely contributing factor to vulvar pain, and, therefore, if the patient is a candidate for the rehabilitative procedure. If so, I familiarize the patient with the device that they will use at home for their twice daily exercise. Home exercise parameters are then prescribed according to the personal needs of the patient. Follow-up includes monitoring of the patients progress with return office visits every four to eight weeks for re-evaluation and exercise modification. Patients are encouraged to ask questions and clearly understand the procedure and are free to make contact between sessions to answer any questions or request any information. Each patient receives a take-home package including a complete report of the evaluation findings, recommendations for vulvar self-care and sexual activity and detailed information on acquiring the at-home training device from a federally licensed Durable Medical Equipment Company along with specific settings and exercise parameters.
INITIAL SESSION IS APPROXIMATELY 2 HOURS 30 MINUTES AND SUBSEQUENT SESSIONS ARE APPROXIMATELY
1 HOUR 30 MINUTES
FOR THE INITIAL EVALUATION SESSION THE PROFESSIONAL SERVICE FEE IS $450.00 AND FOR EACH SUBSEQUENT SESSION THE PROFESSIONAL SERVICE FEE IS $250.00. PATIENTS ARE REQUIRED TO PAY THE PROFESSIONAL SERVICE FEE AT TIME OF SERVICE THROUGH CASH IN US DOLLARS AND PAYPAL. PATIENTS WILL BE PROVIDED WITH A STANDARD BILL SUITABLE FOR SUBMISSION TO THEIR INSURANCE COMPANY FOR OUT OF NETWORK REIMBURSEMENT. PLEASE BE AWARE THAT THERE ARE SEVERAL INSURANCE POLICIES, WHICH WILL NOT REIMBURSE OUT OF NETWORK SERVICE FEES. REIMBURSEMENT IS STRICTLY AN ISSUE BETWEEN THE PATIENT AND THE INSURER AND DR. GLAZER’S PRACTICE MAKES NO REPRESENTATIONS REGARDING INSURANCE REIMBURSEMENT FOR ANY PARTICULAR INSURER AND IS NOT A PROVIDER FOR ANY INSURER,
HOME TRAINING EQUIPMENT COSTS:
THE HOME TRAINING EQUIPMENT INCLUDES A VAGINAL SENSOR WITH GROUND PATCHES, AND A SURFACE ELECTROMYOGRAPHIC BIOFEEDBACK DEVICE. THIS IS AN FDA/CE APPROVED PRESCRIPTION DEVICE AND PATIENTS ARE REFERRED TO A FEDERALLY LICENSED DURABLE MEDICAL EQUIPMENT DISTRIBUTOR (DME) TO ACQUIRE THEIR EQUIPMENT. THE EQUIPMENT CAN BE LEASED OR PURHASED. PURCHASE PRICE IS APPROXIMATELY $425.00. IF YOUR INSURANCE COVERS ANY OF THE COST OF THIS DURABLE MEDICAL EQUIPMENT (CHECK THE DME CLAUSE IN YOUR INSURANCE POLICY) THEN YOU MAY SUBMIT THE EQUIPMENT EXPENSES TO YOUR INSURANCE CARRIER.
COURSE OF TREATMENT:
THE AVERAGE COURSE OF TREATMENT IS APPROXIMATELY 6 to 9 MONTHS WITH AN AVERAGE OF 3 to 4 OFFICE VISITS.
DR. GLAZER’S OFFICE IS LOCATED IN NEW YORK CITY AT:
2166 BROADWAY, #6D
New York, N.Y. 10024
Phone: (212) 563-7045