Using visual reality exposure therapy to manage pain during intrauterine device insertion: a systematic review and meta-analysis

Abstract Background The intrauterine device (IUD) is an effective form of birth control, but its utilization worldwide is low due to discomfort and anxiety during insertion. Virtual reality (VR) technology shows promise in reducing pain during IUD insertion. Aim & objectives This study aims to evaluate the efficacy of VR technology exposure in reducing pain associated with IUD insertions. Search strategy We comprehensively searched Midline, Scopus, Web of Science, and Cochrane Library from inception to April 2024 to include all studies assessing the efficacy of VR integration during IUD insertion. Selection criteria We selected randomized controlled trials that investigate the benefits of VR technology on women undergoing IUD insertion. Data collection and analysis The primary study endpoint was the degree of pain during IUD insertion assessed by the Visual Analogue Scale (VAS). Quality evaluation for included studies was done using the Cochrane Risk of Bias assessment. Results Our search strategy revealed 531 search results. Four clinical trials enrolling 315 women were found adherent to our preselected eligibility criteria. We found a significant reduction in the degree of pain during IUD insertion in the VR group compared to the standard practice group (SMD= -1.69, 95% CI: [-3.20,-0.18]; P= 0.03). None of the meta-analyses for the patients’ anxiety during IUD insertion or post-insertion satisfaction showed statistical significance between the two study groups. Conclusion VR technology demonstrated a notable decrease in pain during IUD insertion compared to standard practice, while no significant differences were observed in patients' anxiety or post-insertion satisfaction between the study groups.