Effectiveness of immersive virtual reality-based interventions for alleviating peri- and post-procedural pain and anxiety in gynecologic settings: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

Non-pharmacological and complementary therapeutic, notably immersive virtual reality-based interventions (IVR), could alleviate pain and anxiety associated with gynecologic procedures.

OBJECTIVE

To evaluate the effectiveness of IVR in reducing peri- and post-procedural pain and anxiety in gynecologic procedures. Secondarily, to determine the safety of IVR.

SEARCH STRATEGY: A systematic review with meta-analysis was conducted, after searching in PubMed/Medline, SCOPUS, Web of Science, CINAHL Complete and PEDro from database inception to September 2025 with no language or publication date restrictions set.

SELECTION CRITERIA: Inclusion criteria were based on the PICOS framework: Population (patients undergoing gynecologic procedures), Intervention (IVR), Comparison (standard care or other therapeutic approaches), Outcomes (pain, anxiety and adverse events) and Study design (randomized controlled trials [RCTs]).

DATA COLLECTION AND ANALYSIS: Pooled effects were calculated using Cohen's standardized mean difference (SMD) and its 95% confidence intervals (95% CI) in a random-effects model. Potential adverse events during IVR exposure were also compiled.

MAIN

RESULTS

A total of 25 randomized controlled trials (RCTs), comprising data from 2438 women (mean age 35.3 ± 12.6 years), were included. Intraprocedural outcomes indicated that IVR significantly decreased both pain (SMD = -0.46, 95% CI: -0.71 to -0.21, P < 0.001) and anxiety (SMD = -0.33, 95% CI: -0.63 to -0.03, P = 0.031). Post-procedurally, IVR yielded further reductions in pain (SMD = -0.81, 95% CI: -1.12 to -0.5, P < 0.001) and anxiety (SMD = -0.76, 95% CI: -1.22 to -0.3, P = 0.001). Reported adverse events were minor and infrequent.

CONCLUSION

This meta-analysis suggests that IVR serves as a highly effective and safe non-pharmacological adjunct for mitigating peri- and post-procedural pain and anxiety in gynecologic settings. Translating these findings into clinical practice could substantially enhance patient care and overall experience.

PROSPERO REGISTRATION: CRD420251000835.