Effects of Listening to Binaural Beats on Anxiety Levels and Pain Scores in Male Patients Undergoing Cystoscopy and Ureteral Stent Removal: A Randomized Placebo-controlled Trial

Diagnostic cystoscopy (DC) and ureteral stent removal (USR) are two common simple procedures in urology practice. DC is generally performed to investigate the etiology of hematuria, recurrent urinary tract infections, lower urinary tract symptoms, and suspected bladder tumor cases.Ureteral stent removal is usually carried out after the placed urethral stent for the treatment of urolithiasis and urethral stricture. In many urology clinics, both procedures are generally performed under local anesthesia. To reduce pain, it is recommended that DC should be performed using a flexible cystoscope. In many urology clinics, USR is performed using a rigid cystoscope in both sexes, as a rigid cystoscope is easier to manipulate during stent removal compared with a flexible cystoscope. Although performed under local anesthesia, both procedures are invasive and can cause increased anxiety levels and pain perception.Anxiety is commonly associated with an increased perception of pain.Therefore, patients who have high anxiety levels experience longer pain and require more analgesics.

Binaural beats have been recommended to reduce anxiety levels and the perception of pain in many treatment modalities.hey were discovered by Dove in 1841 and described in detail by Oster in 1973. Binaural beats are resulted from exposing each ear to two sounds which have steady intensities with different frequencies. A single tone with a midway frequency between the carrier tones is perceived. This frequency also waxes and wanes in amplitudes at a rate equal to the difference between the carrier tones It has been suggested that the human brain alters its dominant wave frequency toward that of the frequency of external stimuli to synchronize neural activity with stimuli from binaural beats.

METHOD

Ethics statement and participant selection

The study was approved by the institutional review board (Approval number and date: 16/15 - 04/07/2019 ). Male patients aged ≥ 18 y with negative urine culture, at least formal schooling (1-8 y of education) who had undergone local DC for various reasons (e.g., hematuria, carcinoma suspicion, follow-up for bladder cancer, and screening of the urethra or prostate) or unilateral USR were included in the study. Informed consent was provided by all the patients who accepted to participate in the study.