WROCLAW, Poland — New research has found that being immersed in a stunning virtual Icelandic landscape can ease the pain caused by uncomfortable medical procedures.
The study compared patients who had rigid cystoscopies with and without Virtual Reality (VR) headsets. The research was presented at the European Association of Urology Congress, EAU21.
Diagnosing and treating bladder cancer usually requires checking the bladder through a cystoscopy, which is perceived by patients as unpleasant and painful. Some patients avoid follow-up and, as a result, suffer uncontrolled and irreversible development of the disease.
Cystoscopy involves the doctor inserting a tube into the urethra that allows them to examine the interior of the urinary tract for abnormal growths, strictures, or other problems.
Rigid cystoscopy may be performed under local anesthesia. It can also be performed under both general and spinal anesthetic, but those procedures bring an additional risk of complications.
In some fields of medicine, virtual reality has been shown to be an effective pain relief tool; for example, in burns patients, while dressings are changed. In these applications, patients have tended to be upright and the virtual reality experience interactive, the study said.
Doctor Wojciech Krajewski and colleagues at the Wroclaw Medical University in Poland recruited 103 patients — with a mean age of 66 years- who were listed for rigid cystoscopy with just local, intraurethral anesthesia.
Individuals were randomized to undergo either classic cystoscopy or the procedure with VR goggles and headphones with an image of the Skogafoss waterfall in Iceland.
During the cystoscopy, the research team measured blood pressure, oxygen saturation, and heart rate in patients, as well as taking pain-related observations using a measurement score called FLACC — observing face, legs, consolability, and cry — which is used in children but here adjusted for adults.
After the procedure, patients were also asked to rate the pain perception and nausea related to the cystoscopy.
The pain scale scores were lower in the Virtual Reality group than the controls, and though nausea and vertigo were higher with the headsets and goggles, patients found it bearable, and no procedures had to stop as a result.
The findings were the same for male, female, first and follow-up cystoscopies, and the researchers believe the technology could be used for other uncomfortable or painful procedures to help reduce patient pain.
“Cystoscopy is uncomfortable for patients, and they can be anxious about it,” Krajewski said.
“My colleagues and I were keen to find new ways to make them more comfortable and had seen VR technology used for younger patients to alleviate pain in interactive ways.”
“In this instance, we wanted to try presenting a calming image, more suited to older patients, and see if we could better support them during their procedures.”
“Patients reported less pain, and this was also reflected in our observations of their experience. VR is certainly an option for pain reduction in cystoscopies, and we are looking into whether it will have the same effect in other medical interventions such as lithotripsy to break down kidney stones or prostate biopsy,” Krajewski said.
Professor James N’Dow, from the University of Aberdeen, who chairs the European Association of Urology Guidelines Office, said improving patients’ experience of the care they received was as important as improving treatment outcomes.
“While it makes sense to avoid general anesthesia whenever possible, telescopic bladder examinations under local anesthetic can be very uncomfortable and frightening for some patients,” N’Dow said.
“This study increases our understanding of how virtual reality can distract patients and reduce their anxiety and pain.”
“What’s needed now is a larger trial, which would also do a cost-benefit analysis, to determine whether this approach should be considered as part of standard clinical practice.”
(With inputs from ANI)
(Edited by Abinaya Vijayaraghavan and Krishna Kakani)
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