Video Eğitimi ve Sanal Gerçeklik ile Prostat Biyopsisinde Hasta Konforunun Artırılması
Year 2026,
Volume: 11 Issue: 1, 52 - 57, 15.03.2026
Murat Beyatlı
,
İsa Dağlı
,
Tuncel Uzel
,
Hasan Samet Güngör
,
Abdurrahman İnkaya
,
Resul Sobay
,
Mehmet Umut Evci
,
Ahmet Tahra
,
Eyüp Veli Küçük
Abstract
Amaç: Bu çalışma, transrektal ultrason (TRUS) eşliğinde prostat biyopsisi uygulanan hastalarda işlem öncesi video tabanlı hasta eğitimi ve işlem sırasında sunulan sanal gerçeklik (VR) desteğinin ağrı şiddeti (VAS) ve aynı koşullar altında tekrar biyopsi olma isteği (WtR) üzerindeki etkilerini değerlendirmeyi amaçladı. Materyal ve Metot: Ocak 2023 – Ağustos 2025 tarihleri arasında prostat kanseri şüphesiyle ilk kez TRUS eşliğinde prostat biyopsisi yapılan 240 hastanın verileri retrospektif olarak incelendi. Hastalar, işlem öncesi video eğitimi alıp almamalarına ve işlem sırasında VR gözlüğü kullanıp kullanmamalarına göre dört gruba ayrıldı. Birincil sonlanım noktası biyopsi sırasındaki ağrı düzeyi (VAS), ikincil sonlanım noktası ise aynı koşullarda tekrar biyopsi olma isteğiydi (WtR). Bulgular: Dört grup arasında VAS ve WtR skorları anlamlı farklılık gösterdi (her ikisi için p < 0,001). Video + VR grubunda ortalama VAS skoru en düşük (2,63 ± 1.31) ve ortalama WtR skoru en yüksek (8,25 ± 0.98) bulundu. Kontrol grubunda ise VAS en yüksek (4,03 ± 1.62) ve WtR en düşük (6,92 ± 1.03) değerlerdeydi. Komplikasyon oranı genel olarak düşük izlendi (%4,6) ve gruplar arasında anlamlı farklılık saptanmadı (p = 0,343). Sonuç: TRUS eşliğinde prostat biyopsisi öncesi video tabanlı eğitimin, işlem sırasında VR desteğiyle birlikte uygulanması ağrıyı anlamlı şekilde azaltmaktadır ve hastaların aynı koşullarda yeniden biyopsi olma isteğini artırmaktadır. Bu invaziv olmayan, düşük maliyetli ve kolay uygulanabilir yaklaşım, hasta deneyimini iyileştirmek için etkili bir strateji sunmaktadır.
Ethical Statement
Çalışmamız, Ümraniye Eğitim ve Araştırma Hastanesi Etik Kurulu tarafından onaylanmıştır (Tarih: 11.09.2025, karar no: 259). Çalışma, Helsinki Bildirgesi'nde belirtilen ilkelere uygun olarak yürütülmüştür.
References
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1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi:10.3322/caac.21763
-
2. European Association of Urology. Prostate cancer: diagnostic evaluation. https://uroweb.org/guidelines/prostate-cancer/chapter/diagnostic-evaluation. Accessed October 27, 2025.
-
3. Loeb S, Vellekoop A, Ahmed HU, et al. Systematic review of complications of prostate biopsy. Eur Urol. 2013;64(6):876-892. doi:10.1016/j.eururo.2013.05.049
-
4. Inal G, Adsan O, Ugurlu O, Kaygısız O, Kosan M, Cetinkaya M. Comparison of four different anesthesia methods for relief of all pain during transrectal ultrasound-guided prostate biopsy. Int Urol Nephrol. 2008;40(2):335-339. doi:10.1007/s11255-007-9237-3
-
5. De Sio M, D’armiento M, Di Lorenzo G, et al. The need to reduce patient discomfort during transrectal ultrasonography‐guided prostate biopsy: what do we know? BJU Int. 2005;96(7):977-983. doi:10.1111/j.1464-410X.2005.05736.x
-
6. Irani J, Fournier F, Bon D, Gremmo E, Dore B, Aubert J. Patient tolerance of transrectal ultrasound‐guided biopsy of the prostate. Br J Urol. 1997;79(4):608-610. doi:10.1046/j.1464-410X.1997.00120.x
-
7. Galetti TP, Dal Moro F, Milani C, Pinto F, Pagano F. Patient’s preparation in order to reduce pain, anxiety and complications of TRUS prostatic biopsies. Eur Urol Suppl. 2002;1(6):3-7. doi:10.1016/S1569-9056(02)00051-9
-
8. Deivasigamani S, Adams ES, Kotamarti S, et al. Comparison of procedural anxiety and pain associated with conventional transrectal ultrasound prostate biopsy to magnetic resonance imaging-ultrasound fusion-guided biopsy: a prospective cohort trial. Prostate Cancer Prostatic Dis. 2024;27(2):294-299. doi:10.1038/s41391-023-00760-5
-
9. Rodriguez A, Kyriakou G, Leray E, Lobel B, Guillé F. Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal lidocaine gel: review of the literature. Eur Urol. 2003;44(2):195-200. doi:10.1016/S0302-2838(03)00188-X
-
10. Maccagnano C, Scattoni V, Roscigno M, et al. Anaesthesia in transrectal prostate biopsy: which is the most effective technique? Urol Int. 2011;87(1):1-13. doi:10.1159/000327827
-
11. Vanoli S, Grobet-Jeandin E, Windisch O, Valerio M, Benamran D. Evolution of anxiety management in prostate biopsy under local anesthesia: a narrative review. World J Urol. 2024;42(1):43. doi:10.1007/s00345-023-04723-2
-
12. Tarhan H, Cakmak O, Unal E, et al. The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy. Can Urol Assoc J. 2014;8(11-12):E894-E900. doi:10.5489/cuaj.2208
-
13. Teh JJ, Pascoe DJ, Hafeji S, et al. Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis. BMC Med. 2024;22(1):64. doi:10.1186/s12916-024-03266-6
-
14. Genç H, Korkmaz M, Akkurt A. The effect of virtual reality glasses and stress balls on pain and vital findings during transrectal prostate biopsy: a randomized controlled trial. J Perianesth Nurs. 2022;37(3):344-350. doi:10.1016/j.jopan.2021.09.006
-
15. Toraman RL, Eskici Ilgin V. Effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy: a randomized controlled trial. Biol Res Nurs. 2024;26(4):485-497. doi:10.1177/10998004241236154
-
16. Ozturk E, Ozden E, Isikdogan M, et al. The effect of listening to music on pain and anxiety scores during office based transperineal prostate biopsy: a prospective study. Urology. 2025;196:254-259. doi:10.1016/j.urology.2024.11.064
-
17. Packiam VT, Nottingham CU, Cohen AJ, Eggener SE, Gerber GS. No effect of music on anxiety and pain during transrectal prostate biopsies: a randomized trial. Urology. 2018;117:31-35. doi:10.1016/j.urology.2018.04.014
-
18. Chesnut GT, Zareba P, Sjoberg DD, et al. Patient-reported pain, discomfort, and anxiety during magnetic resonance imaging-targeted prostate biopsy. Can Urol Assoc J. 2020;14(5):E202-E208. doi:10.5489/cuaj.6102
-
19. Nakai Y, Tanaka N, Matsubara T, et al. Effect of prolonged duration of transrectal ultrasound-guided biopsy of the prostate and pre-procedure anxiety on pain in patients without anesthesia. Res Rep Urol. 2021;13:111-120. doi:10.2147/RRU.S297703
-
20. Kaver I, Mabjeesh NJ, Matzkin H. Randomized prospective study of periprostatic local anesthesia during
transrectal ultrasound-guided prostate biopsy. Urology. 2002;59(3):405-408.
-
21. Pareek G, Armenakas NA, Fracchia JA. Periprostatic nerve blockade for transrectal ultrasound guided biopsy of the prostate: a randomized, double-blind, placebo controlled study. J Urol. 2001;166(3):894-897. doi:10.1016/S0022-5347(05)65859-4
-
22. Nazir B. Pain during transrectal ultrasound-guided prostate biopsy and the role of periprostatic nerve block: what radiologists should know. Korean J Radiol. 2014;15(5):543-553. doi:10.3348/kjr.2014.15.5.543
-
23. Saraçoğlu T, Ünsal A, Taşkın F, Sevinçok L, Karaman CZ. The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound-guided prostate biopsy. Diagn Interv Radiol. 2012;18(2):195-199. doi:10.4261/1305-3825.DIR.4643-11.1
-
24. Jang H, Moon HN, Kim JI, Bae SR, Han CH, Park BH. Comparison of intrarectal heated lidocaine gel and periprostatic nerve block for pain control in transrectal ultrasound-guided prostate biopsy: a randomized controlled non-inferiority trial. Prostate Int. 2023;11(1):8-12. doi:10.1016/j.prnil.2022.07.004
-
25. Kim JI, Sohn DW, Park BH. Combination of intrarectal heated lidocaine gel and periprostatic nerve block for pain control during transrectal ultrasound-guided prostate biopsy: a prospective randomized trial. Investig Clin Urol. 2025;66(2):130-136. doi:10.4111/icu.20240312
-
26. Issa MM, Bux S, Chun T, et al. A randomized prospective trial of intrarectal lidocaine for pain control during transrectal prostate biopsy: the Emory University experience. J Urol. 2000;164(2):397–399. doi:10.1016/S0022-5347(05)67369-7
-
27. Chang SS, Alberts G, Wells N, Smith JA, Cookson MS. Intrarectal lidocaine during transrectal prostate biopsy: results of a prospective double-blind randomized trial. J Urol. 2001;166(6):2178–2180. doi:10.1016/S0022-5347(05)65529-2
-
28. Cevik I, Ozveri H, Dillioglugil O, Akdaş A. Lack of effect of intrarectal lidocaine for pain control during transrectal prostate biopsy: a randomized prospective study. Eur Urol. 2002;42(3):217-220. doi:10.1016/S0302-2838(02)00275-0
-
29. Berquin C, Perletti G, Develtere D, et al. Transperineal vs. transrectal prostate biopsies under local anesthesia: a prospective cohort study on patient tolerability and complication rates. Urol Oncol. 2023;41(9):388.e17-388.e23. doi:10.1016/j.urolonc.2023.05.020
-
30. Bryant RJ, Marian IR, Williams R, et al. Local anaesthetic transperineal biopsy versus transrectal prostate biopsy in prostate cancer detection (TRANSLATE): a multicentre, randomised, controlled trial. Lancet Oncol. 2025;26(5):583-595. doi:10.1016/S1470-2045(25)00100-7
Enhancing Patient Comfort in Prostate Biopsy Through Video Education and Virtual Reality
Year 2026,
Volume: 11 Issue: 1, 52 - 57, 15.03.2026
Murat Beyatlı
,
İsa Dağlı
,
Tuncel Uzel
,
Hasan Samet Güngör
,
Abdurrahman İnkaya
,
Resul Sobay
,
Mehmet Umut Evci
,
Ahmet Tahra
,
Eyüp Veli Küçük
Abstract
Objective: This study aimed to evaluate the effects of video-based preprocedural patient education and intraoperative virtual reality (VR) support on pain intensity (VAS) and willingness to undergo repeat biopsy (WtR) in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and Methods: The data of 240 patients who underwent their first TRUS-guided prostate biopsy for suspected prostate cancer between January 2023 and August 2025 were retrospectively analyzed. Patients were divided into one of four groups based on whether they received preprocedural video education and whether they wore VR headsets during the procedure. The primary endpoint was the pain level during biopsy (VAS), and the secondary endpoint was willingness to undergo a repeat biopsy under the same conditions (WtR). Results: Pain intensity (VAS) and willingness-to-repeat (WtR) scores differed significantly among the four groups (both p < 0.001), with the Video + VR group showing the lowest mean VAS score (2.63 ± 1.31) and the highest mean WtR score (8.25 ± 0.98), while the control group had the highest VAS (4.03 ± 1.62) and the lowest WtR (6.92 ± 1.03). Overall complication rates were low and similar between groups (4.6%, p = 0.343). Conclusion: Video-based preprocedural education combined with real-time VR support during TRUS-guided biopsy significantly reduces pain and increases patients’ willingness to undergo a repeat procedure. This non-invasive, low-cost, and easily applicable alternative represents an effective strategy to improve patient experience.
Ethical Statement
Our study was approved by the Umraniye Training and Research Hospital Ethics Committee (Date: 11.09.2025, decision no: 259). The study was conducted in accordance with the principles outlined in the Declaration of Helsinki.
References
-
1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi:10.3322/caac.21763
-
2. European Association of Urology. Prostate cancer: diagnostic evaluation. https://uroweb.org/guidelines/prostate-cancer/chapter/diagnostic-evaluation. Accessed October 27, 2025.
-
3. Loeb S, Vellekoop A, Ahmed HU, et al. Systematic review of complications of prostate biopsy. Eur Urol. 2013;64(6):876-892. doi:10.1016/j.eururo.2013.05.049
-
4. Inal G, Adsan O, Ugurlu O, Kaygısız O, Kosan M, Cetinkaya M. Comparison of four different anesthesia methods for relief of all pain during transrectal ultrasound-guided prostate biopsy. Int Urol Nephrol. 2008;40(2):335-339. doi:10.1007/s11255-007-9237-3
-
5. De Sio M, D’armiento M, Di Lorenzo G, et al. The need to reduce patient discomfort during transrectal ultrasonography‐guided prostate biopsy: what do we know? BJU Int. 2005;96(7):977-983. doi:10.1111/j.1464-410X.2005.05736.x
-
6. Irani J, Fournier F, Bon D, Gremmo E, Dore B, Aubert J. Patient tolerance of transrectal ultrasound‐guided biopsy of the prostate. Br J Urol. 1997;79(4):608-610. doi:10.1046/j.1464-410X.1997.00120.x
-
7. Galetti TP, Dal Moro F, Milani C, Pinto F, Pagano F. Patient’s preparation in order to reduce pain, anxiety and complications of TRUS prostatic biopsies. Eur Urol Suppl. 2002;1(6):3-7. doi:10.1016/S1569-9056(02)00051-9
-
8. Deivasigamani S, Adams ES, Kotamarti S, et al. Comparison of procedural anxiety and pain associated with conventional transrectal ultrasound prostate biopsy to magnetic resonance imaging-ultrasound fusion-guided biopsy: a prospective cohort trial. Prostate Cancer Prostatic Dis. 2024;27(2):294-299. doi:10.1038/s41391-023-00760-5
-
9. Rodriguez A, Kyriakou G, Leray E, Lobel B, Guillé F. Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal lidocaine gel: review of the literature. Eur Urol. 2003;44(2):195-200. doi:10.1016/S0302-2838(03)00188-X
-
10. Maccagnano C, Scattoni V, Roscigno M, et al. Anaesthesia in transrectal prostate biopsy: which is the most effective technique? Urol Int. 2011;87(1):1-13. doi:10.1159/000327827
-
11. Vanoli S, Grobet-Jeandin E, Windisch O, Valerio M, Benamran D. Evolution of anxiety management in prostate biopsy under local anesthesia: a narrative review. World J Urol. 2024;42(1):43. doi:10.1007/s00345-023-04723-2
-
12. Tarhan H, Cakmak O, Unal E, et al. The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy. Can Urol Assoc J. 2014;8(11-12):E894-E900. doi:10.5489/cuaj.2208
-
13. Teh JJ, Pascoe DJ, Hafeji S, et al. Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis. BMC Med. 2024;22(1):64. doi:10.1186/s12916-024-03266-6
-
14. Genç H, Korkmaz M, Akkurt A. The effect of virtual reality glasses and stress balls on pain and vital findings during transrectal prostate biopsy: a randomized controlled trial. J Perianesth Nurs. 2022;37(3):344-350. doi:10.1016/j.jopan.2021.09.006
-
15. Toraman RL, Eskici Ilgin V. Effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy: a randomized controlled trial. Biol Res Nurs. 2024;26(4):485-497. doi:10.1177/10998004241236154
-
16. Ozturk E, Ozden E, Isikdogan M, et al. The effect of listening to music on pain and anxiety scores during office based transperineal prostate biopsy: a prospective study. Urology. 2025;196:254-259. doi:10.1016/j.urology.2024.11.064
-
17. Packiam VT, Nottingham CU, Cohen AJ, Eggener SE, Gerber GS. No effect of music on anxiety and pain during transrectal prostate biopsies: a randomized trial. Urology. 2018;117:31-35. doi:10.1016/j.urology.2018.04.014
-
18. Chesnut GT, Zareba P, Sjoberg DD, et al. Patient-reported pain, discomfort, and anxiety during magnetic resonance imaging-targeted prostate biopsy. Can Urol Assoc J. 2020;14(5):E202-E208. doi:10.5489/cuaj.6102
-
19. Nakai Y, Tanaka N, Matsubara T, et al. Effect of prolonged duration of transrectal ultrasound-guided biopsy of the prostate and pre-procedure anxiety on pain in patients without anesthesia. Res Rep Urol. 2021;13:111-120. doi:10.2147/RRU.S297703
-
20. Kaver I, Mabjeesh NJ, Matzkin H. Randomized prospective study of periprostatic local anesthesia during
transrectal ultrasound-guided prostate biopsy. Urology. 2002;59(3):405-408.
-
21. Pareek G, Armenakas NA, Fracchia JA. Periprostatic nerve blockade for transrectal ultrasound guided biopsy of the prostate: a randomized, double-blind, placebo controlled study. J Urol. 2001;166(3):894-897. doi:10.1016/S0022-5347(05)65859-4
-
22. Nazir B. Pain during transrectal ultrasound-guided prostate biopsy and the role of periprostatic nerve block: what radiologists should know. Korean J Radiol. 2014;15(5):543-553. doi:10.3348/kjr.2014.15.5.543
-
23. Saraçoğlu T, Ünsal A, Taşkın F, Sevinçok L, Karaman CZ. The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound-guided prostate biopsy. Diagn Interv Radiol. 2012;18(2):195-199. doi:10.4261/1305-3825.DIR.4643-11.1
-
24. Jang H, Moon HN, Kim JI, Bae SR, Han CH, Park BH. Comparison of intrarectal heated lidocaine gel and periprostatic nerve block for pain control in transrectal ultrasound-guided prostate biopsy: a randomized controlled non-inferiority trial. Prostate Int. 2023;11(1):8-12. doi:10.1016/j.prnil.2022.07.004
-
25. Kim JI, Sohn DW, Park BH. Combination of intrarectal heated lidocaine gel and periprostatic nerve block for pain control during transrectal ultrasound-guided prostate biopsy: a prospective randomized trial. Investig Clin Urol. 2025;66(2):130-136. doi:10.4111/icu.20240312
-
26. Issa MM, Bux S, Chun T, et al. A randomized prospective trial of intrarectal lidocaine for pain control during transrectal prostate biopsy: the Emory University experience. J Urol. 2000;164(2):397–399. doi:10.1016/S0022-5347(05)67369-7
-
27. Chang SS, Alberts G, Wells N, Smith JA, Cookson MS. Intrarectal lidocaine during transrectal prostate biopsy: results of a prospective double-blind randomized trial. J Urol. 2001;166(6):2178–2180. doi:10.1016/S0022-5347(05)65529-2
-
28. Cevik I, Ozveri H, Dillioglugil O, Akdaş A. Lack of effect of intrarectal lidocaine for pain control during transrectal prostate biopsy: a randomized prospective study. Eur Urol. 2002;42(3):217-220. doi:10.1016/S0302-2838(02)00275-0
-
29. Berquin C, Perletti G, Develtere D, et al. Transperineal vs. transrectal prostate biopsies under local anesthesia: a prospective cohort study on patient tolerability and complication rates. Urol Oncol. 2023;41(9):388.e17-388.e23. doi:10.1016/j.urolonc.2023.05.020
-
30. Bryant RJ, Marian IR, Williams R, et al. Local anaesthetic transperineal biopsy versus transrectal prostate biopsy in prostate cancer detection (TRANSLATE): a multicentre, randomised, controlled trial. Lancet Oncol. 2025;26(5):583-595. doi:10.1016/S1470-2045(25)00100-7