The Effect Of Metronome Rhythm On Pain, Anxiety, And Patient Experience During Cystoscopy: A Prospective Clinical Study.

OBJECTIVE: To evaluate the effect of metronome-based rhythmic auditory stimulation at different tempos on pain, anxiety, satisfaction, and willingness to undergo repeat flexible cystoscopy. METHODS: This single-center, prospective, non-randomized observational study included 250 patients undergoing first-time office-based flexible cystoscopy under local anesthesia. Patients were allocated into five groups: control, 60 bpm, 80 bpm, 100 bpm, and 120 bpm, with 50 patients in each group. Metronome stimulation was delivered from room entry until completion of cystoscopy. The primary outcome was overall procedural pain assessed using a visual analogue scale (VAS). Secondary outcomes included VAS satisfaction, willingness to undergo repeat cystoscopy, change in State-Trait Anxiety Inventory-State score, hemodynamic changes, and procedural duration. RESULTS: Baseline demographic, psychological, and hemodynamic parameters were comparable between groups. Overall procedural pain differed significantly across groups (p<0.001), with all metronome tempos showing lower pain scores than control. The 100 bpm group demonstrated the most favorable outcomes, including lower pain scores, higher satisfaction, greater willingness to repeat cystoscopy, greater reduction in state anxiety, and lower pulse rate increase compared with control. No significant differences were observed in blood pressure changes or procedural duration. CONCLUSION: Metronome-based rhythmic auditory stimulation is a simple, low-cost, and feasible non-pharmacological intervention for improving procedural comfort during flexible cystoscopy. A 100 bpm rhythm may offer the greatest clinical benefit.