O R I G I N AL AR TIC L E Open Access
The effect of music in gynaecological office
procedures on pain, anxiety and
satisfaction: a randomized controlled trial
, I. M. A. Reinders
, S. A. Slockers
, E. H. M. N. Westen
, J. W. M. Maas
and M. Y. Bongers
Background: Pain can interfere with office procedures in gynaecology. The aim of this study is to measure the
positive effect of music in gynaecological office procedures.
Methods: A randomized controlled trial was performed between October 2014 and January 2016. Women
scheduled for an office hysteroscopy or colposcopy were eligible for randomization in the music group or control
group. Stratification for hysteroscopy and colposcopy took place. The primary outcome is patients’ level of pain
during the procedure measured by the visual analogue scale (VAS). Secondary outcomes include patients’ level of
pain after the procedure, anxiety and satisfaction of patient and doctor.
Results: No positive effect of music on patients’ perception of pain during the procedure was measured, neither
for the hysteroscopy group (57 mm vs. 52 mm) nor for the colposcopy group (32 mm vs. 32 mm). Secondary
outcomes were also similar for both groups.
Conclusions: This study showed no positive effect of music on patients’ level of pain, anxiety or satisfaction of
patient or doctor for office hysteroscopy and colposcopy. We believe a multimodal approach has to be used to
decrease patient distress in terms of pain and anxiety, with or without music.
Trial registration: Dutch Trial Register, NTR4924
Keywords: Pain, Anxiety, Music, Office procedures, Hysteroscopy, Colposcopy
Today, office procedures in gynaecology are widely used
to diagnose and directly treat gynaecological abnormalities
[1–3]. However, pain and anxiety remain problems that
may impede the procedure and can contribute to a nega-
tive experience for the patient [4–8].
Listening to music could be an easy and non-invasive
way to decrease pain and anxiety. However, the litera-
ture is not clear about the efficacy of music therapy.
Music for pain relief of any type was previously exam-
ined in a review including 31 studies. The studies
showed a high variation in the results. Pooled data
demonstrated a significant reduction of 0.4 points on a
0–10 scale, which is of doubtful clinical importance .
Research on this topic in gynaecology is also not conclu-
sive. The meta-analysis of Wang et al. suggested a positive
effect of music regarding pain, anxiety and satisfaction for
patients undergoing endoscopic surgery. For patients
undergoing colposcopy, no effect was found . This
result is the sum of two randomized controlled trials
with contradictory results regarding the impact of
music in office colposcopy, with no effect versus an
almost 2 point decrease in pain measured by the VAS
(0–10) in favour of music therapy [7, 11, 12]. Only
one article could be found on the effect of music dur-
ing office hysteroscopy. Angioli et al. showed a posi-
tive effect of the use of music with a reduction of
pain and anxiety .
The effect of music in gynaecological office procedures
on satisfaction of patients is less frequently examined.
* Correspondence: N.email@example.com
Department of Obstetrics and Gynaecology, Máxima Medical Centre,
Veldhoven, The Netherlands
Full list of author information is available at the end of the article
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
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Mak et al. Gynecological Surgery (2017) 14:14