Virtual Reality for Pain Reduction During Transvaginal Ultrasound in Women With Endometriosis: A Randomized Controlled Trial

OBJECTIVE: To evaluate whether virtual reality (VR) glasses reduce pain perception during transvaginal ultrasound (TVUS) in women with endometriosis. DESIGN: Open-label randomized controlled trial. SETTING: University-affiliated medical center. PARTICIPANTS: A total of 117 premenopausal women with a confirmed diagnosis of endometriosis. INTERVENTIONS: TVUS performed with or without the use of immersive VR glasses. RESULTS: A total of 117 women were randomized to either the VR group (n = 58) or the control group (n = 59). Although mean pain scores were not significantly different (VR: 3.2 ± 2.6 vs. control: 4.0 ± 3.0; p = 0.08), moderate-to-severe pain was reported less frequently in the VR group (33.9% vs. 55.2%; p = 0.027). In a multivariate logistic regression analysis, VR use (OR = 0.26, 95% CI: 0.10-0.63; p = 0.0027), current pain [odds ratio (OR) = 1.31, 95% CI: 1.02-1.69], and anticipated pain (OR = 1.22, 95% CI: 1.00-1.49) were shown to be independent predictors of moderate-to-severe pain during TVUS. Among women with high anticipated pain [Numeric rating scale (NRS) ≥ 4], the VR group reported significantly lower actual pain scores compared to controls [3.0 (1.0-5.0) vs. 6.0 (4.0-7.5), respectively, p = 0.037]. CONCLUSION: Use of VR during TVUS in women with endometriosis reduced the frequency of moderate-to-severe pain and mitigated the impact of anticipated pain on pain perception. VR may be a beneficial non-pharmacologic adjunct in pelvic imaging for women with endometriosis. TRIAL REGISTRATION NUMBER: NCT04711408.