Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

See all formats and pricing
More options …

Music to reduce pain and anxiety in cystoscopy: a systematic review and meta-analysis

Herney Andrés García-Perdomo
  • Corresponding author
  • UROGIV Research Group at Universidad del Valle, Cali, Colombia
  • Associate Professor School of Medicine at Universidad del Valle, Cali, Colombia
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Laura M. Montealegre Cardona / Maria Juliana Cordoba-Wagner / James A. Zapata-Copete
  • UROGIV Research Group at Universidad del Valle, Cali, Colombia
  • Universidad Libre, Epidemiology Department, Cali, Colombia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-10-12 | DOI: https://doi.org/10.1515/jcim-2018-0095



To assess the effectiveness and harms of music to reduce anxiety and pain in cystoscopy.


We searched MEDLINE (OVID), EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to nowadays. We included clinical trials, involving the assessment of the effect of music in cystoscopy. The primary outcomes were pain and anxiety measured by any scale and the secondary outcomes were length of stay, physiological parameters (blood pressure or heart rate) and adverse effects. Cochrane Collaboration tool was used to assess the risk of bias. We performed the statistical analysis in R and reported information about mean difference (MD) with 95% CI. Heterogeneity was evaluated using the I2 test.


We included six studies in our qualitative and quantitative analysis. Five studies used a flexible cystoscope and the other one performed the procedure with a rigid cystoscope. Music was played during the procedure in five studies, while the other was before it. All studies compared music vs. no intervention. Almost all items were assessed as low risk of bias; however, the allocation concealment was unclear in all the studies. We found a MD of −1.33 (95% CI −2.45 to −0.21) (I2=97.2%) favoring music for pain and a MD of −8.42 (95% CI −15.02, −1.82) (I2=99.6%) was found, favoring music for anxiety.


Playing music might be an effective intervention that lowers pain and anxiety in patients who undergo cystoscopy.

Keywords: anxiety; cystoscopy; meta-analysis; music; pain


  • [1]

    Cataño J, Tobar V. Medicion de la percepcion del dolor durante la cistoscopia transuretral. Urol Colomb 2009;18:39–44.Google Scholar

  • [2]

    Raheem OA, Mirheydar H S, Lee H J, Patel ND, Godebu E, Sakamoto K. Does listening to music during office-based flexible cystoscopy decrease anxiety in patients: a prospective randomized trial. J Endourol. 2015;29:791–6Web of ScienceCrossrefPubMedGoogle Scholar

  • [3]

    Falavolti C, Sergi F, Petitti T, Buscarini M. Does listening to music during flexible cystoscopy and bladder biopsy decrease patient's pain? J Clin Urol 2017;10:129–32.Web of ScienceCrossrefGoogle Scholar

  • [4]

    Yeo JK, Cho DY, Oh MM, Park SS, Park MG. Listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction in patients: a pilot randomized controlled trial. J Endourol 2013;27:459–62.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [5]

    Zhang Z, Wang X, Xu C, Zhang C, Cao Z, Xu W, et al. Music reduces panic: an initial study of listening to preferred music improves male patient discomfort and anxiety during flexible cystoscopy. J Endourol 2014;28:739–44.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [6]

    Kamioka H, Tsutani K, Yamada M, Park H, Okuizumi H, Tsuruoka K, et al. Effectiveness of music therapy: a summary of systematic reviews based on randomized controlled trials of music interventions. Patient Prefer Adherence 2014;8:727–54.PubMedWeb of ScienceGoogle Scholar

  • [7]

    Higgins J, Green S, Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration The Cochrane Collaboration, 2011. www.cochrane-handbook.org.

  • [8]

    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009 Jul 21;6:1–6.Web of ScienceGoogle Scholar

  • [9]

    Team RC. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2017.Google Scholar

  • [10]

    Elkhoury F, Mirheydar H, Jabaji R, Palazzi K, Patel N, Godebu E, et al. Listening to music during flexible cystoscopy does not decrease anxiety or pain: a veterans affairs prospective randomized controlled trial [Internet]. Western Section AUA. 2013 Annual meeting, 2013. Available at: http://epostersonline.com/aua2013/?q=node/181&page=4

  • [11]

    Dixon L, Coscione A, Winkler M. Mp14-20 the impact of music on pain and anxiety experienced in patients undergoing flexible cystoscopy: a prospective randomized controlled trial. J Urol 2014;191:e175.CrossrefGoogle Scholar

  • [12]

    Madson AT, Silverman MJ. The effect of music therapy on relaxation, anxiety, and pain perception. J Music Ther 2010;XLVII:220–32.Web of ScienceGoogle Scholar

  • [13]

    Park MG, Kang KS, Yeo JK, Cho DY, Park SS. Listening to music decreases patient′s anxiety, pain and dissatisfaction during cystoscopy a prospective randomized controlled trial. J Urol 2012;187:e612.CrossrefWeb of ScienceGoogle Scholar

  • [14]

    Nilsson U. The anxiety- and pain-reducing effects of music interventions: a systematic review. Aorn J 2008;87:780–807.CrossrefGoogle Scholar

About the article

Received: 2018-06-10

Accepted: 2018-09-06

Published Online: 2018-10-12

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Complementary and Integrative Medicine, 20180095, ISSN (Online) 1553-3840, DOI: https://doi.org/10.1515/jcim-2018-0095.

Export Citation

© 2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Comments (0)

Please log in or register to comment.
Log in