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Biomedical subjects

Howard I Glazer

Publications and source records attributed to Howard I Glazer.

5 recordsLinked to original sources
PubMed2006

Pelvic floor muscle biofeedback in the treatment of urinary incontinence: a literature review.

Biofeedback is efficacious in the training of the pelvic floor musculature in order to enhance continence. This article reviews the anatomy and physiology of micturition as the underlying rationale for pelvic floor muscle biofeedback in the treatment of urinary incontinence. It critically reviews 28 studies published in peer reviewed journals from 1975 to 2005 that were prospective, randomized studies with parametric statistical analyses, operationally defined patient selection criteria, treatment protocols and outcome measures. The overall mean treatment improvement for patients undergoing biofeedback for urinary incontinence was 72.61%. In 21 of 35 (60%) paired comparisons, biofeedback demonstrated superior symptomatic outcome to control or alternate treatment groups. Larger studies and a standardization of technology and methodology are required for more conclusive determinations.

Biofeedback, Psychology↗
PubMed2006

Subjective and objective outcomes of botulinum toxin type A treatment in vestibulodynia: pilot data.

OBJECTIVE: To collect pilot data on the efficacy of intramuscular botulinum toxin type A (BTX/A) injection into the levator ani muscles to relieve coital pain, reduce pelvic floor tension and instability, and reduce vestibular hyperalgesia in vestibulodynia. STUDY DESIGN: Two subjects meeting diagnostic criteria for vestibulodynia were treated with 20 units and 40 units of BTX/A at 12-week intervals. Outcomes included a visual analogue scale (VAS), weekly coital pain diaries, surface electromyography (sEMG) and a vulvar algesiometer. RESULTS: BTX/A modestly reduced coital pain in 1 patient and was ineffective in the other. Pelvic floor hypertonicity and variability were markedly reduced in both patients, but negligible changes occurred in vestibular hyperalgesia. The patient with greater pelvic floor tension had more of a reduction in diary-rated coital pain 2 weeks after the injection (29% vs. 9%) and on the VAS at 12 weeks (15% vs. 3%). CONCLUSION: BTX/A injections may be effective in reducing coital pain in vestibulodynia with levator ani tenderness but have little effect on vestibular allodynia. The relationship between pelvic floor hypertonicity and decreased coital pain suggests that vestibulodynia may be a variant of chronic regional pain syndrome. The dose and volume of BTX/A injected may be related to the degree of relief.

Adult↗
PubMed2002

Web-enabled Glazer surface electromyographic protocol for the remote, real-time assessment and rehabilitation of pelvic floor dysfunction in vulvar vestibulitis syndrome. A case report.

BACKGROUND: The browser-based software for the Glazer pelvic floor muscle surface electromyography (sEMG) protocol can be used for remote, real-time assessment and treatment over the Internet. CASE: The initial application of this system is reported for a patient meeting clinical diagnostic criteria for vulvar vestibulitis syndrome. The patient underwent pelvic floor muscle sEMG evaluation in the Washington, D.C., office of the second author, remotely controlled by the first author from his office in New York City. Pelvic muscle sEMG findings were consistent with previous reports on vestibulitis patients, and rehabilitative exercises were prescribed. Follow-up evaluations and home training normalized the sEMG and resulted in elimination of pain. CONCLUSION: Remote, real-time pelvic floor muscle sEMG in the diagnosis and treatment of vulvar vestibulitis is a novel application of telemedicine with demonstrated efficacy, permitting this technology to be available to all practitioners.

Computer Communication Networks↗
PubMed2001

A randomized comparison of group cognitive--behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis.

This study compared group cognitive-behavioral therapy (12-week trial), surface electromyographic biofeedback (12-week trial), and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Subjects were 78 women randomly assigned to one of three treatment conditions and assessed at pretreatment, posttreatment and 6-month follow-up via gynecological examinations, structured interviews and standard questionnaires pertaining to pain (Pain Rating Index and Sensory scale of the McGill Pain Questionnaire, vestibular pain index, pain during intercourse), sexual function (Sexual History Form, frequency of intercourse, Information subscale of the Derogatis Sexual Functioning Inventory), and psychological adjustment (Brief Symptom Inventory). As compared with pretreatment, study completers of all treatment groups reported statistically significant reductions on pain measures at posttreatment and 6-month follow-up, although the vestibulectomy group was significantly more successful than the two other groups. However, the apparent superiority of vestibulectomy needs to be interpreted with caution since seven women who had been assigned to this condition did not go ahead with the intervention. All three groups significantly improved on measures of psychological adjustment and sexual function from pretreatment to 6-month follow-up. Intent-to-treat analysis supported the general pattern of results of analysis by-treatment-received. Findings suggest that women with dyspareunia can benefit from both medical and behavioral interventions.

Adult↗