Desai Sethi Researchers Study Use of Virtual Reality to Lessen Pain, Anxiety During Vasectomy

Researchers from the Desai Sethi Urology Institute, part of the University of Miami Miller School of Medicine, have launched a study to determine if wearing virtual reality headsets during in-office vasectomy helps relieve patients of procedure-related pain and anxiety.

A patient wearing a VR headset during a procedure.
The study aims to determine if wearing virtual reality headsets during in-office vasectomy helps relieve patients of procedure-related pain and anxiety.

Miller School researchers have partnered for the study with the company Smileyscope, which has developed virtual reality hardware to meet or exceed health care standards. Company experts created the technology in this trial specifically as a virtual reality treatment for pain relief during office procedures performed using local anesthesia.

“Studies suggest that virtual reality can safely decrease pain in children undergoing IV procedures. We think virtual reality might also play a role in distracting and comforting adult patients. Our hypothesis is that the technology could diminish the pain and anxiety that adult men associate with vasectomy and potentially many other in-office procedures,” said study investigator Ranjith Ramasamy, M.D., associate professor and director of the Miller School’s Reproductive Urology Program.

“We are also comparing virtual with augmented reality to determine if a static scene, in this case a beach with music, helps more or less to diminish pain and anxiety than an interactive magic show.”

One of the biggest concerns for men considering a vasectomy is pain or anxiety related to pain, said Akhil Muthigi, M.D., a study investigator and reproductive urology fellow working with Dr. Ramasamy.

“A lot of patients want the vasectomy, but in the end the anxiety or fear is too high, and they don’t go through with it,” said Dr. Muthigi. “We will see if this technology helps to make the actual experience in the clinic a less painful experience, which would be a win for not only the patients but also the urologists doing these common procedures.”

An image of a beach.
Patients will be randomized into three groups: One will wear VR headsets with a static beach scene and music, another will wear headsets with an interactive magic show, and the third will use no additional technology during the procedure.

Studying Effects of Headsets

During the next six months, researchers will recruit 150 to 180 men undergoing in-office vasectomy at the Desai Sethi Urology Institute. The men will be randomized into three groups: One group will wear virtual reality headsets with a static beach scene and music during the procedure; another group will wear headsets that feature a magic show that they can interact with by eye movements; and the third group will undergo the traditional procedure with no additional technology.

Researchers are using patient surveys to measure pain and anxiety scores before, during, and after the procedure, according to study investigator Farhan Qureshi, an M.D./Ph.D. student at the Miller School.

“Another thing that’s novel about this study is that we’re using Fitbit wearable devices to measure physiological pain measures, including heart rate, skin temperature, and oxygenation levels before, during, and after the procedure,” Qureshi said.

The study is timely, according to Dr. Ramasamy.

“Demand for vasectomy procedures in the U.S. is trending up, especially with Roe vs. Wade being overturned,” Dr. Ramasamy said. “I was among the authors on a study recently published in the journal Cureus in which we found that internet searches for vasectomy jumped more than 120% following the leaked Supreme Court draft regarding Roe v. Wade.”

For the study, Miller School researchers partnered with Smileyscope, an Australian-based company that developed the innovative and evidence-based virtual reality technology for use in health care.

“During vasectomy, pain is generated at the procedure site, and the conventional approach is to control pain at that site. Importantly, we know pain is perceived in the brain. We are testing whether Smileyscope’s virtual reality can reduce pain by changing pain perception in the brain,” said Smileyscope’s Chief Medical Officer Paul Leong, M.B.B.S., Ph.D. “Using bespoke virtual reality during vasectomy has not been [studied in a clinical trial] before, and we are delighted to work with Dr. Ramasamy and colleagues.”

The use of virtual reality could translate to many types of in-office procedures, according to Dr. Muthigi.

“Vasectomy is one of the more common procedures we do in our clinic. But there are dozens of in-office procedures in the urology world that might benefit from the use of virtual reality; for example, prostate biopsies used to diagnose prostate cancer and cystoscopy to diagnose bladder cancer,” Dr. Muthigi said. “If the technology pans out in studies, clinicians might be using virtual reality to distract and calm patients having all types of in-office procedures in the future.”

Tags: Department of Urology, Desai Sethi Urology Institute, Dr. Ranjith Ramasamy, Miller School of Medicine, pain management, Reproductive Urology Program, Smileyscope, vasectomy, virtual reality