title: Treatment efficacy of virtual reality distraction in the reduction of pain and anxiety during cystoscopy.
abstract: OBJECTIVE
  Assessment of virtual reality (VR) distraction for alleviating pain and anxiety during flexible cystoscopy. Cystoscopy is a common ambulatory procedure performed in Urology and can be associated with moderate pain and anxiety. Sophisticated distraction techniques are not used with cystoscopy and VR has not been studied for this procedure. We designed a prospective, randomized, controlled trial assessing the efficacy of VR for alleviating pain and anxiety during flexible cystoscopy.
  
  
  METHODS
  Adult men referred for cystoscopy were randomized into a control or VR group. Subjects were given preprocedure and postprocedure questionnaires addressing anxiety, pain, and time spent thinking about pain. Vitals signs and galvanic skin monitors were used as objective measures. The control group underwent routine cystoscopy and the VR group underwent cystoscopy with VR. Physicians answered a postprocedure questionnaire assessing the difficulty of the exam. All questionnaires used a visual analog score for assessment.
  
  
  RESULTS
  23 patients enrolled in the control group and 22 in the VR group. Mean scores and Student's t-test were employed to analyze the data. No data endpoints showed a statistically significant difference between the 2 groups.
  
  
  CONCLUSIONS
  We concluded no benefit to VR distraction mitigating pain in male patients during cystoscopy.
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Walker
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: George J S
authors.initials: GJ
authors.lastname: Kallingal
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: John E
authors.initials: JE
authors.lastname: Musser
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: Raymond
authors.initials: R
authors.lastname: Folen
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: Melba C
authors.initials: MC
authors.lastname: Stetz
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96850-5000.
authors.forename: Joseph Y
authors.initials: JY
authors.lastname: Clark
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D003558:Cystoscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D011446:Prospective Studies; D018910:Video Games; D063367:Virtual Reality Exposure Therapy