Integrating a Virtual Reality Mask in Functional Urological Surgeries Under Local Anesthesia: A Prospective Cohort Study on Utility and Satisfaction - 27/12/24

Doi : 10.1016/j.urology.2024.11.007

Paolo Geretto ^a,^b,^⁎ , Sabrina De Cillis ^a,^c, Luigi Candela ^a, Thibault Germain ^a, Nicolas Vienney ^a, Margaux Felber ^a, Véronique Phé ^a
^a Department of Urology, Tenon Academic Hospital, Assistance-Publique – Hôpitaux de Paris, Sorbonne University, Paris, France
^b Division of Neuro-Urology, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
^c Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy

^⁎Address correspondence to: Paolo Geretto, M.D., Sorbonne University, Tenon Academic Hospital, Assistance-Publique – Hôpitaux de Paris, Paris 10126, Italy.Sorbonne University, Tenon Academic Hospital, Assistance-Publique – Hôpitaux de ParisParis10126Italy

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 27 December 2024

Résumé

Objective

To evaluate the safety and efficacy of a virtual reality (VR) mask as a distraction tool during minimally invasive functional urological interventions as part of the local anesthesia protocol.

Methods

This is a single-center prospective observational pilot cohort study which included all consecutive patients undergoing intradetrusor botulinum toxin injection, sacral neuromodulation, and urethral bulking agent injection with combined anesthetic protocol composed by local anesthesia and a VR mask (Hypno VR virtual reality mask, Strasbourg, France). Preoperative and postoperative evaluation included the State-Trait Anxiety Inventory (STAI) index. Intraoperatively, a 4-point Likert anxiety rating scale and a visual analog scale (VAS) pain score were assessed. Vital signs were measured preoperative and intraoperatively. Postoperatively, 2 questionnaires exploring patient satisfaction were administered. The evaluated outcomes were the tolerability of the device and patient’s reported intraoperative pain and anxiety.

Results

Thirty-nine patients were included. Mean age was 64 years. Eleven patients (28%) were affected by neurological conditions. Two patients experienced subjective discomfort. Preoperative and intraoperative mean arterial pressure was 105 and 111 mmHg (P = .01), respectively. Preoperative and intraoperative mean heart rate was 72 and 75 bpm (P = .12), respectively. Preoperative and postoperative STAI index were 34.8 + −10 and 32.8 + −10.3 (P = .88). Mean Likert anxiety scale value was 2.2 + −1.1, mean intraoperative VAS score was 5.3 + −2.5. Thirty-four (87%) patients declared themselves satisfied with the surgical procedure and 36 (92.3%) patients would have recommended the same procedure to a relative.