a2211b18e557541859990c86e649e0d2 pmc_11765363.pdf afac1953b1d4c576fa840c6963df0a677d898034 pmc_11765363.pdf beabe51a367284c7b84416e42ebc22a6a4f17c33a5863afe55072ee73bffafd1 pmc_11765363.pdf Title: Effectiveness of Virtual Reality in Reducing Pain and Stress During Office Hysteroscopy: A Randomized Controlled Trial Subject: Introduction: Office hysteroscopy (OH) offers a “see and treat” strategy, enabling most gynecological conditions to be addressed outside the operating room without anesthesia. Despite its convenience, the associated pain and stress remain significant barriers to its widespread success among women. Both pharmacological and non-pharmacological interventions have been explored to mitigate these challenges, albeit with mixed outcomes. Methods: This study aimed to evaluate the effectiveness of virtual reality (VR) in reducing pain and stress associated with OH using objective measurements. Results: Our findings indicate that VR significantly reduced pain during OH compared to the control group (-1.08, 95%CI; -1.93–0.23, on the Visual Analogue Scale (VAS), p = 0.013) and 10 min post-procedure (-1.24, 95%CI; -1.99–0.48, p = 0.001), without significant effects on stress-related variables. Stratified analyses further revealed that the efficacy of VR in pain reduction is influenced by individual patient characteristics, with greater effectiveness observed in women with lower baseline stress, premenopausal status and a history of childbirth, regardless of vaginal delivery. Conclusions: VR represents a promising strategy for managing OH-associated pain, with its effectiveness largely depending on patient-specific variables. Keywords: office hysteroscopy; virtual reality; pain; anxiety; stress; gynecology; analgesia; trial Author: Josep Estadella Tarriel, Josep Perelló Capó, Marta Simó González, Marta Bailón Queiruga, Jordi Real Gatius, Mar Gomis-Pastor, Diana Marre and Elisa Llurba Olivé Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Sun Jan 12 08:07:25 2025 CET ModDate: Sun Jan 12 08:15:04 2025 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1357500 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- QSHGWZ+VnURWPalladioL Type 1 Custom yes yes yes 10 0 PKYKLV+URWPalladioL-Roma Type 1 Custom yes yes yes 16 0 CAVOJS+URWPalladioL-Bold Type 1 Custom yes yes yes 22 0 ZSSNEA+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 EILUJF+CMSY10 Type 1 Builtin yes yes yes 32 0 LDMKPM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 72 0 LDMKPO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 75 0 LDMKPP+PalatinoLinotype CID TrueType Identity-H yes yes yes 78 0 LDMLAA+PalatinoLinotype TrueType WinAnsi yes yes no 84 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 100 0 OVNEXW+EURM10 Type 1 Builtin yes yes yes 108 0 LDMKPL+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 116 0 LDMKPM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 122 0 LDMKPO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 125 0 LDMKPP+PalatinoLinotype CID TrueType Identity-H yes yes yes 128 0 LDMLAA+PalatinoLinotype TrueType WinAnsi yes yes no 134 0 LDMLHO+PalatinoLinotype TrueType MacRoman yes yes no 137 0 LDMNKD+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 140 0 LDMPBL+PalatinoLinotype,Italic TrueType MacRoman yes yes no 151 0 LDMKPM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 154 0 LDMKPO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 157 0 LDMKPP+PalatinoLinotype CID TrueType Identity-H yes yes yes 160 0 LDMLAA+PalatinoLinotype TrueType WinAnsi yes yes no 166 0 LDMLHO+PalatinoLinotype TrueType MacRoman yes yes no 169 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-13 02:52:02 CET RepresentationInformation: pmc_11765363.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-02-12 02:33:00 CET Size: 1357500 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 428 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Study Participants and Eligibility Criteria Destination: subsection.2.2 Item: Title: Recruitment and Randomization Process Destination: subsection.2.3 Item: Title: Hysteroscopy Procedure Destination: subsection.2.4 Item: Title: VR Intervention Destination: subsection.2.5 Item: Title: Outcomes and Measurements Destination: subsection.2.6 Item: Title: Statistical Analysis Destination: subsection.2.7 Item: Title: Results Destination: section.3 Children: Item: Title: Baseline Characteristics of the Study Groups Destination: subsection.3.1 Item: Title: Effects of VR on Pain Perception and Stress Destination: subsection.3.2 Item: Title: STAI-T Stratification Destination: subsection.3.3 Item: Title: Menopausal Stage Stratification Destination: subsection.3.4 Item: Title: Pregnancy History Stratification Destination: subsection.3.5 Item: Title: Vaginal Delivery Stratification Destination: subsection.3.6 Item: Title: Patient Satisfaction Regarding the Hysteroscopic Procedure and the Use of VR Destination: subsection.3.7 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Effectiveness of Virtual Reality in Reducing Pain and Stress During Office Hysteroscopy: A Randomized Controlled Trial Author: Josep Estadella Tarriel, Josep Perelló Capó, Marta Simó González, Marta Bailón Queiruga, Jordi Real Gatius, Mar Gomis-Pastor, Diana Marre and Elisa Llurba Olivé Subject: Introduction: Office hysteroscopy (OH) offers a “see and treat” strategy, enabling most gynecological conditions to be addressed outside the operating room without anesthesia. Despite its convenience, the associated pain and stress remain significant barriers to its widespread success among women. Both pharmacological and non-pharmacological interventions have been explored to mitigate these challenges, albeit with mixed outcomes. Methods: This study aimed to evaluate the effectiveness of virtual reality (VR) in reducing pain and stress associated with OH using objective measurements. Results: Our findings indicate that VR significantly reduced pain during OH compared to the control group (-1.08, 95%CI; -1.93 0.23, on the Visual Analogue Scale (VAS), p = 0.013) and 10 min post-procedure (-1.24, 95%CI; -1.99 0.48, p = 0.001), without significant effects on stress-related variables. Stratified analyses further revealed that the efficacy of VR in pain reduction is influenced by individual patient characteristics, with greater effectiveness observed in women with lower baseline stress, premenopausal status and a history of childbirth, regardless of vaginal delivery. Conclusions: VR represents a promising strategy for managing OH-associated pain, with its effectiveness largely depending on patient-specific variables. Keywords: office hysteroscopy; virtual reality; pain; anxiety; stress; gynecology; analgesia; trial Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Sun Jan 12 08:07:25 CET 2025 ModDate: Sun Jan 12 08:15:04 CET 2025 ID: 0x0d27d4179fb13260650e9fbe3e69fa96, 0x0d27d4179fb13260650e9fbe3e69fa96 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: PKYKLV+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 246 FontDescriptor: FontName: PKYKLV+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: EILUJF+CMSY10 FontSubset: true FirstChar: 0 LastChar: 21 FontDescriptor: FontName: EILUJF+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 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