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Virtual reality for pain control during shock wave lithotripsy: a randomized controlled study

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Abstract

Purpose

Although external shock wave lithotripsy (SWL) is an outpatient procedure generally not requiring anesthesia or sedation, patients may experience pain during the procedure. The aim of this study is to evaluate whether a virtual reality device is effective in reducing patient-reported pain during the procedure, consequently leading to exposure to higher energy levels and better clinical outcomes.

Methods

Inclusion criteria for SWL were according to the latest EAU guidelines on urolithiasis. Patients were randomized 1:1 in two groups (SWL with VR and SWL without VR). The primary outcome of this randomized, controlled study (RCT) was an overall difference in pain levels determined by VAS-scores. Secondary outcomes were differences in comfort levels, determined by Likert-scale scores, clinical success and total delivered energy.

Results

Between January 2019 and September 2021, we enrolled 166 patients; 84 were randomized to the control arm and 82 to the VR arm. Patients without VR experienced significantly more pain compared to the VR group (mean VAS-score = 4.94 vs 4.01; p = 0.011). The mean total delivered energy was significantly higher in the VR group compared to the control group (55.2 J vs. 48.8 J; p = 0‘037). No significant differences in comfort levels and clinical success were found.

Conclusion

This study supports the use of VR as a method of pain relief during shock wave lithotripsy. Higher energy levels can be achieved during the treatment while comfort levels remained equal; this however did not lead to improved clinical success.

Registration number and name of trial registry

Clinicaltrials.gov: NCT05183269. Virtual reality for pain control during extracorporeal shock wave lithotripsy: prospective, comparative, randomized study at a single institution. https://clinicaltrials.gov/ct2/show/NCT05183269?term=shock+wave+lithotripsy&cond=virtual+reality&cntry=BE&draw=2&rank=1.

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Data availability

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

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Funding

Authors did not received funding for this study.

Author information

Authors and Affiliations

  1. Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium

    Laurens Weynants, Brecht Chys, Pieter D’hulst, Luc Merckx & Jeroen Van Besien

  2. Department of Urology, University Hospital Ghent, Ghent, Belgium

    Laurens Weynants & Thomas Tailly

Authors
  1. Laurens Weynants
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  2. Brecht Chys
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  3. Pieter D’hulst
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  4. Luc Merckx
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  5. Jeroen Van Besien
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  6. Thomas Tailly
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Contributions

Dr. LW: data collection or management, data analysis, manuscript writing/editing. Dr. BC: data collection or management. Dr. PD: protocol/project development. Dr. LM: protocol/project development. Dr. JVB: manuscript writing/editing, supervision. Dr. TT: manuscript writing/editing, supervision.

Corresponding author

Correspondence to Laurens Weynants.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the ethical committee of Sint-Lucas Hospital Ghent (project 2018-44).

Informed consent

All patients provided written informed consent prior to enrolment.

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Weynants, L., Chys, B., D’hulst, P. et al. Virtual reality for pain control during shock wave lithotripsy: a randomized controlled study. World J Urol 41, 589–594 (2023). https://doi.org/10.1007/s00345-023-04280-8

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  • DOI: https://doi.org/10.1007/s00345-023-04280-8

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