Virtual Reality-Based Interventions for Pain and Anxiety in Outpatient Gynecologic Procedures: A Systematic Review.

PURPOSE: This systematic review and meta-analysis aimed to evaluate the effectiveness of Virtual Reality (VR) as a nonpharmacological intervention for reducing pain and anxiety in women undergoing outpatient gynecological procedures. METHODS: Conducted in accordance with PRISMA guidelines, this review analyzed randomized controlled trials (RCTs) published between January 2014 and March 2026. Comprehensive searches were performed across seven electronic databases. The methodological quality was assessed using the Cochrane Risk of Bias 2 tool. FINDINGS: A total of 11 RCTs (n = 1,222 patients) met the inclusion criteria, primarily focusing on office hysteroscopy, hysterosalpingography, and intrauterine device insertion. The pooled analysis demonstrated a statistically significant reduction in pain scores (Z = 4.25, P < .0001) and anxiety levels in the VR group compared to standard care. While high statistical heterogeneity (I² = 92%) was observed, likely due to variations in VR content and patient characteristics, VR interventions consistently led to significantly higher patient satisfaction and procedural tolerance. Even in studies where pain reduction was nonsignificant, patients reported a strong preference for VR in future procedures. CONCLUSION: VR-based interventions appear to be a highly effective digital therapeutic adjunct for office gynecologic procedures. Beyond reducing procedural pain, VR also contributes to anxiety reduction, improved patient satisfaction, and enhanced procedural tolerance by providing psychological immersion and cognitive distraction. Incorporating VR into perioperative protocols can improve clinical outcomes and patient comfort without the side effects of pharmacological sedation.