Bracey S. et al., 2026: . Investigating Using Virtual Reality to Provide Enhanced Consent and Support Patient Counseling for Patients Undergoing Shockwave Lithotripsy at University Hospital Southampton.

Bracey S, Reynolds P, Pietropaolo A, Bamerni D, Tear L, Davis T, Frascheri M, Somani B.
J Endourol. 2026 May 25:8927790261451805. doi: 10.1177/08927790261451805. Epub ahead of print.

Abstract

Introduction: This research explores the use of virtual reality (VR) as a tool to improve the consenting process for shockwave lithotripsy (SWL). We investigated how patients experienced VR and its impact on their understanding, emotions, and pain levels.

Patients and methods: Patients attending clinic for their SWL treatment were prospectively recruited to experience a 3-minute-long VR animation. This animation outlined the SWL procedure based on the British and European urolithiasis guidelines and enabled visualization of urinary anatomy. Participants then responded to questionnaires, giving insight into their levels of understanding, emotional status, and pain.

Results: Two hundred participants fully completed all the questionnaires. VR use significantly improved participants' understanding and confidence in explaining the SWL procedure, alongside significantly reducing nervousness. Participants reported improvements in all positive emotions and reductions in all negative emotions. VR was rated as significantly more accessible and helpful based on patient-reported outcome measures than current resources, with 76% of participants reporting a strong preference for its inclusion in future treatment. Compared with previous SWL research, the mean postprocedural pain score (1.86) was lower, suggesting that VR may help to improve pain tolerance.

Conclusions: VR shows great potential to enhance the consenting process for SWL. VR interventions can improve patient understanding, strengthening informed consent. They can also enhance the consenting experience through reducing negative emotions such as anxiety, while improving positive emotions such as satisfaction. Because of altered emotional status and improved understanding, VR may also have a role in reducing pain perception, potentially providing a nonpharmacologic alternative to traditional analgesics.

Comment Peter Alken

“Patients should be given the option of whether they would like VR included in their consenting process, and it should be considered for all patients. Traditional consenting tools should still be available, but this research suggests that VR be superior.” I do not see this substantiated in the study because VR was no compared to traditional information. I wonder if the total time of patient information was much longer  than usual,  the patients were impressed  by the care and felt the special interest in their understanding of the whole procedure. Taking more care of the patient than usual might be a key to the good results of VR information.

Peter Alken