Skip to main content

Advertisement

SpringerLink
Log in

Prospective randomized controlled trial to evaluate effectiveness of virtual reality to decrease anxiety in office-based flexible cystoscopy patients

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effectiveness of immersive VR distraction technology in alleviating anxiety and pain during flexible cystoscopy.

Methods

We prospectively recruited 270 study participants who qualified for flexible cystoscopy and randomly assigned them to experimental and control groups. The experimental group consisted of 135 patients who employed a VR set during flexible cystoscopy, and the control group consisted of 135 patients who underwent the procedure without a VR set. Patient anxiety was determined quantitatively according to the State-Trait Anxiety Inventory. A visual analog scale for assessing pain intensity, satisfaction, and willingness to repeat the procedure was evaluated. In addition, difference in the hemodynamic parameter was also examined.

Results

The study findings demonstrated that the use of a VR set during flexible cystoscopy significantly improved the anxiety level over that of the control group (p = 0.001). Furthermore, this intervention led to a significantly increased level of satisfaction and willingness to repeat the procedure and a decrease in hemodynamic variables, specifically, systolic pressure, diastolic pressure, and heart rate (p = 0.001 in each case). Nonetheless, there were no significant differences between the groups with respect to the basic characteristic data, pain intensity, or oxygen saturation.

Conclusions

Based on the present study, immersive VR can measurably decrease anxiety and increase satisfaction and willingness to repeat the procedure during flexible cystoscopy.

Trial registration date

14 September 2019; number: TCTR20190914002.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Abbreviations

VR:

Virtual reality

VAS:

Visual analog scale

STAI-SA:

State-Trait Anxiety Inventory—State Anxiety

References

  1. Gao J, Tian DW, Zhou DS, Wu CL (2021) Flexible cystoscopy can improve anxiety and subjective feelings of bladder cancer patients during follow-up. Wideochir Inne Tech Maloinwazyjne 16(2):397–402

    PubMed  Google Scholar 

  2. Ellis G, Pridgeon S, Lamb BW, Awsare NS, Osaghae S, Smith SG et al (2014) Psychological distress in out-patients undergoing flexible cystoscopy for the investigation of bladder cancer. J Clin Urol 8(3):196–201

    Article  Google Scholar 

  3. Seklehner S, Engelhardt PF, Remzi M, Fajkovic H, Saratlija-Novakovic Z, Skopek M et al (2016) Anxiety and depression analyses of patients undergoing diagnostic cystoscopy. Qual Life Res 25(9):2307–2314

    Article  Google Scholar 

  4. Ketsuwan C, Leenanupunth C, Phengsalae Y, Sangkum P, Kongchareonsombat W, Kaewjai N et al (2021) Prospective randomized controlled trial to evaluate the effectiveness of watching movies to decrease anxiety during extracorporeal shock wave lithotripsy. Res Rep Urol 13:97–104

    PubMed  PubMed Central  Google Scholar 

  5. Kyriakides R, Jones P, Geraghty R, Skolarikos A, Liatsikos E, Traxer O et al (2018) Effect of music on outpatient urological procedures: a systematic review and meta-analysis from the European Association of Urology Section of Uro-Technology. J Urol 199(5):1319–1327

    Article  Google Scholar 

  6. Gezginci E, Iyigun E, Kibar Y, Bedir S (2018) Three distraction methods for pain reduction during cystoscopy: a randomized controlled trial evaluating the effects on pain, anxiety, and satisfaction. J Endourol 32(11):1078–1084

    Article  Google Scholar 

  7. Gunendran T, Briggs RH, Wemyss-Holden GD, Neilson D (2008) Does increasing hydrostatic pressure during flexible cystoscopy improve patient comfort: a randomized, controlled study. Urology 72(2):255–258

    Article  Google Scholar 

  8. Hetou K, Halstuch D, Lavi A, Nair SM, Gan AML, Huynh MJ et al (2021) A randomized controlled trial of a modified cystoscopy technique using the peak-end rule in order to improve pain and anxiety. Urology 154:33–39

    Article  Google Scholar 

  9. Koller D, Goldman RD (2012) Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs 27(6):652–681

    Article  Google Scholar 

  10. Radianti J, Majchrzak TA, Fromm J, Wohlgenannt I (2020) A systematic review of immersive virtual reality applications for higher education: design elements, lessons learned, and research agenda. Comput Educ 147:103778

    Article  Google Scholar 

  11. Gold JI, SooHoo M, Laikin AM, Lane AS, Klein MJ (2021) Effect of an immersive virtual reality intervention on pain and anxiety associated with peripheral intravenous catheter placement in the pediatric setting: a randomized clinical trial. JAMA Netw Open 4(8):e2122569

    Article  Google Scholar 

  12. Dunn A, Patterson J, Biega CF, Grishchenko A, Luna J, Stanek JR et al (2019) A novel clinician-orchestrated virtual reality platform for distraction during pediatric intravenous procedures in children with hemophilia: randomized controlled trial. JMIR Serious Games 7(1):e10902

    Article  Google Scholar 

  13. Hoffman HG, Patterson DR, Carrougher GJ, Sharar SR (2001) Effectiveness of virtual reality-based pain control with multiple treatments. Clin J Pain 17(3):229–235

    Article  CAS  Google Scholar 

  14. Furman E, Jasinevicius TR, Bissada NF, Victoroff KZ, Skillicorn R, Buchner M (2009) Virtual reality distraction for pain control during periodontal scaling and root planing procedures. J Am Dent Assoc 140(12):1508–1516

    Article  Google Scholar 

  15. Song YS, Song ES, Kim KJ, Park YH, Ku JH (2007) Midazolam anesthesia during rigid and flexible cystoscopy. Urol Res 35(3):139–142

    Article  CAS  Google Scholar 

  16. Calleary JG, Masood J, Van-Mallaerts R, Barua JM (2007) Nitrous oxide inhalation to improve patient acceptance and reduce procedure related pain of flexible cystoscopy for men younger than 55 years. J Urol 178(1):184–188 (discussion 8)

    Article  CAS  Google Scholar 

  17. Ozkan TA, Koprulu S, Karakose A, Dillioglugil O, Cevik I (2017) Does using alprazolam during outpatient flexible cystoscopy decrease anxiety and pain? Arch Esp Urol 70(9):800–805

    PubMed  Google Scholar 

  18. Raheem OA, Mirheydar HS, Lee HJ, Patel ND, Godebu E, Sakamoto K (2015) Does listening to music during office-based flexible cystoscopy decrease anxiety in patients: a prospective randomized trial. J Endourol 29(7):791–796

    Article  Google Scholar 

  19. Kelsaka E, Karakaya D, Baris S, Sarihasan B, Dilek A (2011) Effect of intramuscular and intravenous lidocaine on propofol induction dose. Med Princ Pract 20(1):71–74

    Article  Google Scholar 

  20. Becker DE, Rosenberg M (2008) Nitrous oxide and the inhalation anesthetics. Anesth Prog 55(4):124–132

    Article  Google Scholar 

  21. Moon JY, Shin J, Chung J, Ji SH, Ro S, Kim WH (2018) Virtual reality distraction during endoscopic urologic surgery under spinal anesthesia: a randomized controlled trial. J Clin Med 8(1):2

  22. Yu CP, Lee HY, Luo XY (2018) The effect of virtual reality forest and urban environments on physiological and psychological responses. Urban For Urban Green 35:106–114

    Article  Google Scholar 

  23. Walker MR, Kallingal GJ, Musser JE, Folen R, Stetz MC, Clark JY (2014) Treatment efficacy of virtual reality distraction in the reduction of pain and anxiety during cystoscopy. Mil Med 179(8):891–896

    Article  Google Scholar 

  24. Łuczak M, Nowak Ł, Chorbińska J, Galik K, Kiełb P, Łaszkiewicz J, et al (2021) Influence of virtual reality devices on pain and anxiety in patients undergoing cystoscopy performed under local anaesthesia. J Pers Med 11(11):1214

Download references

Acknowledgements

We want to express our deepest gratitude to the patients, doctors, and nurses who participated in the study and acknowledge the statistical calculation support provided by the Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Chinnakhet Ketsuwan, Wijittra Matang, Wattanachai Ratanapornsompong, Premsant Sangkum, Yada Phengsalae, Wisoot Kongchareonsombat & Mutita Jongwannasiri

Authors
  1. Chinnakhet Ketsuwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wijittra Matang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wattanachai Ratanapornsompong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Premsant Sangkum
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yada Phengsalae
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wisoot Kongchareonsombat
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mutita Jongwannasiri
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CK: project development, data analysis, and manuscript writing. WM: data collection and data analysis. WR: data analysis. PS: manuscript editing. YP: data collection and data analysis. WK: manuscript editing. MJ: project development, data analysis, and manuscript editing.

Corresponding author

Correspondence to Mutita Jongwannasiri.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

This study was approved by our institutional review board (COA. MURA2020/409). Informed consent was obtained from all the individual participants included in the study. All methods were performed in accordance with approved guidelines.

Consent to participate

Informed consent was obtained from all the individual participants included in the study.

Consent for publication

Written informed consent for publication of the participants’ clinical details and/or clinical images was obtained from each patient or the patient’s parent(s)/guardian(s)/relative(s).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ketsuwan, C., Matang, W., Ratanapornsompong, W. et al. Prospective randomized controlled trial to evaluate effectiveness of virtual reality to decrease anxiety in office-based flexible cystoscopy patients. World J Urol 40, 2575–2581 (2022). https://doi.org/10.1007/s00345-022-04142-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-022-04142-9

Keywords

Search

Navigation