The role of music in outpatient prostate biopsy: A comprehensive literature review

Prostate biopsy is a standard urological procedure and a valuable tool for identifying prostate cancer. To assess the effect of music on outpatient prostate biopsy, we aimed to conduct a systematic review of literature to understand if music reduced the use of analgesics and anxiolytics. The systematic review was performed in line with the Cochrane guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The databases searched included MEDLINE, Scopus, CINAHL, Clinicaltrials.gov, EMBASE, Cochrane library, and Google Scholar, from inception of databases to February 2021. The primary outcome measures were the effect of music on pain and anxiety from the procedure. The initial search yielded 212 articles and after going through titles and abstracts, and six studies (570 patients) were included for the final review. It included five randomized-controlled trials and one case–control study. These studies were done in Korea, USA, Taiwan, and Turkey. Patients had a combination of either local anesthetic gel or periprostatic nerve block or intravenous pethidine. The choice of music was varied and most offered a choice of music to patients. Four of the six studies showed significantly reduced pain and anxiety with the use of music, and the willingness for repeat procedures was higher in two studies. This review has demonstrated that listening to music is associated with reduced anxiety and pain during prostate biopsy. It is likely to, therefore, increase procedural satisfaction, and willingness to undergo the procedure again considering repeated biopsy is sometimes needed in these patients. As music is simple, inexpensive, and easily accessible, it should be routinely offered to patients for outpatient and office-based urological procedures.