The Influence of Music on Perceived Pain and Levels of Anxiety While Undergoing Transperineal Prostate Biopsy: The VIVALDI Trial

Background: Music has been shown to reduce pain and anxiety during invasive procedures such as transrectal ultrasound-guided prostate biopsy, but its role during transperineal prostate biopsy (TPBx) has not yet been investigated. Objective: To evaluate the effect of music listening on pain perception, anxiety, and patient satisfaction in men undergoing TPBx in an outpatient setting. Design setting and participants: = 51). Baseline clinical, radiological, and demographic characteristics were collected. Intervention: Patients in the +MUSIC group listened continuously to self-selected music during TPBx, while the control group underwent the same standardized procedure without music. Outcome measurements and statistical analysis: Pain was assessed at predefined procedural time points using a visual analog scale (VAS). Distress was measured pre- and post-procedure using the NCCN Distress Thermometer. Secondary outcomes included satisfaction with pain management, willingness to repeat biopsy, anesthetic requirements, and physiological parameters. Between-group comparisons were performed using the Mann-Whitney U test or Fisher's exact test. Multivariable linear regression models were used to identify independent predictors of pain and satisfaction. Results and limitations: ≤ 0.03). Limitations include the single-center design and relatively small sample size. Conclusions: Music listening during TPBx is a safe, simple, and effective non-pharmacological intervention that significantly reduces pain and anxiety while improving patient satisfaction and procedural experience.