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. 2025 Jun 27;17(2):121-129.
doi: 10.52054/FVVO.2025.48. Epub 2025 Jun 23.

The impact of virtual reality technology in the era of See & Treat hysteroscopy: a randomised controlled trial

Brunella Zizolfi  1 , Virginia Foreste  1 , Maria Giuseppina Trinchillo  1 , Danilo Borrelli  1 , Alessandra Gallo  2 , Maria Chiara De Angelis  3 , Fabiola Nardelli  1 , Attilio Di Spiezio Sardo  1
Affiliations

The impact of virtual reality technology in the era of See & Treat hysteroscopy: a randomised controlled trial

Brunella Zizolfi et al. Facts Views Vis Obgyn. .

Abstract

Background: In the context of outpatient hysteroscopy (OPH), performing a single procedure integrating the operative and diagnostic part is known as "See & Treat hysteroscopy". The virtual reality (VR) technology provides an immersive virtual environment that can provide a non-invasive analgesic. To date, there is limited evidence regarding its use in the OPH setting.

Objectives: To evaluate the feasibility and effectiveness of VR technology for pain and anxiety management in OPH.

Methods: Unblinded, prospective, randomised controlled trial, conducted at the Hysteroscopy Unit of the University of Naples "Federico II" between May and July 2024. Women aged 18-70 years, indicated for OPH, were randomised into a control group (standard OPH care) and an intervention group (OPH care with the addition of a VR headset).

Main outcome measures: Pain and anxiety were assessed through subjective measures: numerical rating scale (NRS) scores before and after the procedure, and objective measures: heart and respiratory rate pre- and during the procedure. Satisfaction, time, and success rates were also evaluated.

Results: Overall, 116 women were enrolled. The VR group compared to the control group reported significantly lower mean standard deviation NRS scores for pain [3.9 (2.7) vs. 5.4 (3.0); mean difference 1.5, 95% confidence interval (CI) 0.4 to 2.5] and anxiety [3.2 (2.1) vs. 4.8 (2.8); mean difference 1.6, 95% CI 0.7 to 2.5] respectively. Regarding satisfaction, 96.5% of the VR group would use the headset again, whereas 3.5% requested its removal. All women in the control group desired a distraction. No serious adverse events were reported.

Conclusions: VR technology proved feasible and effective for pain and anxiety management in OPH, particularly during operative procedures.

What is new?: Its use can support the implementation of the See & Treat philosophy.

Keywords: Outpatient hysteroscopy; pain and anxiety; virtual reality technology.

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Conflict of interest statement

Data sharing: The data that support the findings of this study are available from the corresponding author upon reasonable request. Restrictions apply to the availability of these data due to confidentiality agreements and the sensitive nature of patient information.

Figures

Figure 1
Figure 1
Virtual reality headset (Deepsen VRx Device, Deepsen, DT Didier, Mont d’Or, France).
Figure 2
Figure 2
Consort flow diagram.
See this image and copyright information in PMC

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