Letter to the Editor Regarding the Article “Listening to Music during Outpatient Cystoscopy Reduces Pain and Anxiety and Increases Satisfaction: Results from a Prospective Randomized Study”

Dear editor,

We read with great interest and excitement the randomized controlled study titled “Listening to Music during Outpatient Cystoscopy Reduces Pain and Anxiety and Increases Satisfaction: Results from a Prospective Randomized Study” published by Mumm et al. [1]. In the above-mentioned study, it was clearly demonstrated that listening to music during flexible cystoscopy is a feasible and effective method to reduce the anxiety experienced by patients. Additionally, it was observed that there was an increase in satisfaction and a decrease in the feeling of pain in the groups that listened to music. The idea of increasing patient satisfaction and reducing anxiety in flexible cystoscopy, which is frequently applied in daily urology practice, is tremendous. I congratulate the author in this respect. I would also like to make a few suggestions to make the study more valuable and to shed light on future similar studies.

The strength of this study was its clear format and prospective nature, besides, measuring moods such as anxiety with more than one questionnaire can increase the value of the study. In addition to the existing test, a frequently used anxiety measurement test such as the State-Trait Anxiety Inventory (STAI) could be used. Second, comparison of hemodynamic parameter measurements in surgical interventions performed with local anesthesia could have been added to the study protocol. In a similar study conducted by Ketsuwan et al. [2], where the effect of virtual reality on flexible cystoscopy was examined, hemodynamic parameters such as systolic blood pressure, diastolic blood pressure and heart rate were measured to be statistically significantly lower in the intervention group. Third, gender discrimination was made in the current study, but the effect of prostate volume on the duration of the procedure and pain could also be evaluated in the male population. Fourth, factors that may affect anxiety, such as cultural structure or income level, had been ignored.

Today, many studies are being conducted on surgical anxiety. While some of these focus on anxiety before the surgical procedure, some focus on the anxiety experienced during the procedure. Anxiety and patient dissatisfaction experienced during the procedure may damage the relationship between the doctor and the patient or cause delays in the patient’s diagnosis and treatment. Therefore, studies that reduce the anxiety experienced by patients and increase patient satisfaction during surgical procedures are gaining importance. Recently, I have come across many publications about listening to music during the procedure, as well as video animated information before the procedure and using virtual reality [2, 3]. The medical world is making intense efforts on this issue. I congratulate the author for his contribution to the literature, and I have made my suggestions to guide his future work.