Effects of music and conversation on pain and anxiety levels during transrectal ultrasound-guided prostate biopsy: a randomized-controlled prospective study

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BACKGROUND: Prostate biopsy is the recommended diagnostic test for prostate cancer in patients with abnormal findings on digital rectal examinations (DRE) or elevated PSA (prostate-specific antigen) levels. Biopsies can cause severe anxiety and pain. OBJECTIVE: To evaluate the effects of music and conversation on pain and anxiety in patients undergoing transrectal ultrasound-guided prostate biopsy. DESIGN AND SETTING: Prospective trial at a Tertiary University Hospital in Türkiye. METHODS: A prospective randomized controlled study was conducted. Ninety patients who had abnormal findings on DRE and/or a PSA value greater than 2.5 ng/ml and were scheduled to undergo TRUS-PBx were randomly assigned to one of three groups (n = 30) via the sealed envelope randomization method: control, music, and conversation groups. VAS pain, VAS anxiety, and STAI scores were recorded before and after the procedure. Statistical analysis was performed using One-Way ANOVA and Kruskal-Wallis tests. Pairwise comparison tests were conducted for the parameters that yielded significant differences among the control, conversation, and music groups. For all statistical analyses, a P value < 0.05 was considered statistically significant. RESULTS: Conversation reduced pain and anxiety significantly (P < 0.001 and P = 0.01 respectively). Post-Bx VAS pain and STAI-State scores were lower in the conversation group. Pairwise comparisons revealed significant differences between the music and conversation groups (VAS pain, P < 0.001; STAI-State, P = 0.006). However, pain and STAI-State scores were similar in both the groups (VAS pain P = 0.645; STAI-State P = 0.597). CONCLUSIONS: The study demonstrated that listening to music had no significant effect on pain and anxiety in patients undergoing TRUS-PBx. Conversely, the findings showed that engaging patients in conversation significantly reduced pain and anxiety during the procedure. CLINICAL TRIAL OR SYSTEMATIC REVIEW REGISTRATION: The trial is registered at clinicaltrials.gov (registration number: NCT07006779) and is accessible at https://clinicaltrials.gov/ct2/show/NCT07006779.