Virtual reality for pain relief during office hysteroscopy: a randomized controlled trial

Abstract

Objective Office hysteroscopy (OH) is widely used to diagnose and manage intrauterine pathologies. However, pain remains the primary factor that contributes to OH failure. This study aimed to assess the effect of virtual reality (VR) on pain reduction during OH. Methods A prospective randomized controlled clinical trial was conducted at a university hospital between July and November 2024. The study involved 50 women undergoing OH randomly allocated to receive immersive VR videos during the procedure or standard care. The main outcome measure was self-reported intraoperative pain evaluated using a numerical rating scale. Other measures included satisfaction, duration, and success of the procedure. Results Mean pain scores were 6.16±1.86 in standard care group and 4.88±1.69 in VR group (difference, 1.28; 95% confidence interval [CI], 0.27 to 2.29; P=0.014). After adjusting for other variables, no statistically significant relationship was found between VR and severe pain (odds ratio, 0.75; 95% CI, 0.15 to 3.87; P=0.73); only severe anxiety in women and procedure duration were associated with severe pain. Conclusion Virtual reality did not significantly reduce pain severity during hysteroscopy. However, severe pain was associated with high anxiety and a longer procedure duration. These findings suggest that VR may not effectively mitigate severe pain, whereas managing anxiety and minimizing procedure time could be more effective strategies.