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

Authors

Keywords:

Prostate, Biopsy, Anxiety, Pain, Ultrasound, high-intensity focused, transrectal, Prostate biopsy, Coversation, Music

Abstract

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.

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Author Biographies

Volkan Selmi, Yozgat Bozok University, Yozgat, Türkiye

MD. Urological surgeon; Professor, Faculty of Medicine, Urology Department, Yozgat Bozok University, Yozgat, Türkiye.

Mehmet Sakir Taspinar, Yozgat Bozok University, Yozgat, Türkiye

MD. Urological surgeon; Professor, Faculty of Medicine, Urology Department, Yozgat Bozok University, Yozgat, Türkiye.

Mehmet Caniklioglu, Yozgat Bozok University, Yozgat, Türkiye

MD. Urological surgeon; Professor, Faculty of Medicine, Urology Department, Yozgat Bozok University, Yozgat, Türkiye.

Sercan Sari, Yozgat Bozok University, Yozgat, Türkiye

MD. Urological surgeon; Professor, Faculty of Medicine, Urology Department, Yozgat Bozok University, Yozgat, Türkiye.

Mahmut Akyuz, Afsin State Hospital, Kahramanmaras, Türkiye

MD. Psychiatrist, Department of Psychiatry, Afsin State Hospital, Kahramanmaras, Türkiye.

Levent Isikay, Yozgat Bozok University, Yozgat, Türkiye

MD. Urological surgeon; Professor, Faculty of Medicine, Urology Department, Yozgat Bozok University, Yozgat, Türkiye.

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Published

2026-01-29

How to Cite

1.
Selmi V, Taspinar MS, Caniklioglu M, Sari S, Akyuz M, Isikay L. Effects of music and conversation on pain and anxiety levels during transrectal ultrasound-guided prostate biopsy: a randomized-controlled prospective study. Sao Paulo Med J [Internet]. 2026 Jan. 29 [cited 2026 May 25];144(1):1-6. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/3273

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