Authors (including presenting author) :
Dr. Oi Hang Hoon
Affiliation :
Pamela Youde Nethersole Eastern Hospital
Keyword 4: :
Virtual reality
Introduction :
Transrectal ultrasound (TRUS) guided prostate biopsy is a common diagnostic procedure to diagnose and treat prostate conditions, but it is often associated with patient discomfort, pain, and anxiety. These factors can negatively impact the overall patient experience and may affect procedure tolerance and compliance. Recent advancements in virtual reality (VR) technology offer a promising non-pharmacological approach to pain and anxiety management by providing immersive distraction and relaxation during medical interventions.
Objectives :
This study purpose is to evaluate whether different VR visual and sound settings during TRUS prostate biopsy have an impact on patient-reported pain and anxiety levels.
Methodology :
This was a prospective single-centre observation study. The study population consisted of a total of 39 male patients who were admitted to the TRUS Unit of the Urology Department of Pamela Youde Nethersole Eastern Hospital for prostate biopsy, and consecutively consented to using the VR technology (glasses and headphone). The patients were divided into two groups according to their TRUS biopsy appointment date. Group 1 consisted of patients from July 16 to August 2025 inclusive, where they had VR settings A (soft guitar audio setting, winter landscape visual setting). Group 2 consisted of patients from September 3 to October 22 2025 inclusive, where they had VR settings B (relaxation music audio setting, scuba diving visual setting). A Patient Information Form and the Visual Analogue Scale were used to collect data. Cases that refused to use the VR technology, or had visual impairment were excluded. SPSS version 29.0.0.0 was used for analysis. The pain and anxiety scores for both groups were compared using Mann-Whitney U test.
Result & Outcome :
Among 39 men (age 32-78, median 59), 22 had settings A, and 17 had settings B. In the Settings A group, pain scores ranged from 0 to 10 (mean 3.82, median 3.5), and anxiety scores ranged from 0 to 10 (mean 3.41, median 3). A total of 72.7% of patients reported that they found the VR technology helpful for pain and anxiety control during the TRUS procedure. In the Settings B group, pain scores ranged from 1 to 10 (mean 7.5, median 7), and anxiety scores ranged from 0 to 10 (mean 5.83, median 6). Here, 88.2% of patients reported the VR technology as helpful during the procedure. A statistically significant difference was observed in pain scores between the two groups (p = 0.00804, p < 0.05), while the difference in anxiety scores was not statistically significant (p = 0.3125, p > 0.05). Overall, the Settings A group exhibited lower pain and anxiety scores; however, this difference reached statistical significance only for pain. Settings A (soft guitar audio and winter landscape visuals) demonstrated a statistically significant reduction in pain scores compared to Settings B (relaxation music audio and scuba diving visuals) during TRUS procedure. Overall, VR technology was effective in alleviating both pain and anxiety in patients across both settings, with lower pain and anxiety scores observed in the Settings A group.
