| Summary: | Abstract
BackgroundIntrauterine devices (IUDs) are safe and effective long-acting reversible contraceptive therapies that are also used as minimally invasive treatment for heavy menstrual bleeding, endometrial hyperplasia, and early-stage endometrial cancer. Despite many advantages, IUDs are underused predominantly due to patient discomfort. Although many techniques have been explored previously in the literature, there is currently little consensus on effective analgesic strategies. Virtual reality (VR) has demonstrated moderate benefits in acute pain management and has been explored for outpatient hysteroscopy.
ObjectiveThis study aims to explore the effectiveness of VR in improving patient pain and anxiety during outpatient IUD insertion.
MethodsThis randomized controlled trial compared the use of a VR headset to standard care during IUD insertion in the outpatient clinic setting. VR content was delivered via smartphone and headset, providing patients with a relaxing 3D video environment. Outcomes measured were patient-reported pain and anxiety, as well as satisfaction reported using a questionnaire. Secondary outcomes included clinician-reported ease of insertion and time required to complete the procedure.
ResultsA total of 70 patients were recruited, with 34 randomized to the control group and 36 randomized to VR headset use. Patients with VR headsets reported a mean pain score of 5.5 (SD 3.2) during IUD insertion, which was not significantly different to 4.3 (SD 3.2) for the control group (PPPP
ConclusionsThe use of VR headsets did not significantly alter the pain or anxiety experienced by patients during IUD insertion; however, satisfaction and recommendation that others use VR were high, which may suggest other benefits to their use. In addition, preprocedural anxiety appears to have a significant adverse impact on pain scores and the ability of patients to benefit from the VR headsets. This is an important contribution to the previously ambiguous data regarding VR use for gynecological procedures and highlights a new avenue for improving the patient experience.
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