Published online Apr 12, 2015. doi: 10.5528/wjtm.v4.i1.38
Peer-review started: July 23, 2014
First decision: December 17, 2014
Revised: January 23, 2015
Accepted: March 4, 2015
Article in press: March 5, 2015
Published online: April 12, 2015
AIM: To investigate if music reduces anxiety and pain in the Veterans Affairs population undergoing flexible cystoscopy.
METHODS: This study was reviewed and approved by the University of California, San Diego Human Research Protections Program Institutional Review Board. Patients were prospectively randomized to undergo flexible cystoscopy with or without music. Thirty-eight patients were randomized into either the No Music group (n = 24) or the Music group (n = 14). We used the state-trait anxiety inventory and the visual analog pain scale, respectively. Statistics were generated and compared using an independent t-test and chi-squared tests. P values < 0.05 were considered statistically significant. Outpatient cystoscopy is a safe and useful procedure employed frequently in Urology for diagnosis and evaluation of genitourinary pathologies. However, cystoscopy-related distress cannot be ignored. Three components of outpatient cystoscopy have been evaluated to improve the cystoscopic experience: local anesthetic control, cystoscopic equipment redesign and environmental modification. We reviewed the literature pertaining to these modifications.
RESULTS: The mean age was 65.3 and 67.1 years for men in the No Music and Music groups, respectively. Although, the majority of patients in each group self-identified as Caucasians (66%), African American, Hispanic and other ethnicities represented 13%, 8% and 13% respectively. The majority of patients (68%) reported experiencing hematuria. Thirty-four percent had a history of bladder cancer, and eighteen percent had a history of prostate cancer. Ten patients (26%) admitted to taking antidepressants. Physiologic parameters that correlated to pain and anxiety (systolic blood pressure, diastolic blood pressure, and heart rate) were statistically similar in both groups prior to and after flexible cystoscopy. The median delta anxiety between the No Music and Music groups were not significantly different (0.78 vs -1.46), and the pain scores between the No Music and Music groups (1.5 vs 1.6) were not statistically different (P = 0.28 and P = 0.92, respectively).
CONCLUSION: Preliminary results demonstrate that music does not reduce anxiety or pain associated with flexible cystoscopy.
Core tip: Flexible cystoscopy is a very common in-office procedure performed in urology. There have been several technological advances made in the instrumentation of flexible cystoscopies, however, there have also been advances made in reducing patient pain and anxiety associated with this procedure such as viscous lidocaine jelly and music. We reviewed the literature on effects of modifiable factors on patient pain and anxiety associated with flexible cystoscopy, and also includes preliminary data on a Veterans Affairs randomized prospective trial evaluating the effect of classical music on pain and anxiety associated with flexible cystoscopy.