Objective

Outpatient hysteroscopy is a cost- effective procedure which can help reduce long NHS waiting lists.

However, it is limited by patient pain and anxiety levels, with procedures often abandoned for this reason.

The objective of this Quality Improvement Project is to evaluate the effect of specific, patient-chosen music on pain and anxiety levels, as well as number of abandoned procedures.

Method

Patients undergoing outpatient hysteroscopy for

heavy or post-menopausal bleeding were offered

the option of specific music during the procedure via

smartphone; if declined, a random radio station was

played. Post-procedure, patients completed a

feedback form based on the BSGE satisfaction survey and the Visual Analog Scale for pain. Additional data on variables such as vaginoscopy, anaesthetic type, and cervical dilatation were collected to assess their impact on pain and anxiety.

Results

A total of 30 patients participated: 16 chose specific music (e.g., ABBA, Bon Jovi, mindfulness, piano chill) and 14 listened to generic radio. Those in the music group reported significantly lower pain and anxiety, describing a more relaxed experience. No procedures were abandoned in either group, indicating both audio options supported completion, though patient-chosen music enhanced comfort.

Significant reductions in discomfort were also observed with use of the vaginoscopic technique, simple analgesia 1 hour pre-procedure, and no cervical dilatation— highlighting modifiable procedural factors.
Variables such as BMI, age, parity, bleeding indication, biopsy/polypectomy, Entonox, and local anaesthetic showed no impact on pain or anxiety.

Qualitative feedback emphasized that staff friendliness and professionalism were the most helpful factors—reinforcing the importance of compassionate care alongside technical interventions.

Design

Data was collected prospectively. Patients were separated into those who chose specific music to be played during outpatient hysteroscopy and those who did not. Primary outcome measures were pain levels, anxiety levels and number of procedures abandoned.

Key Insight

��Specific music reduces pain/anxiety

��Vaginoscopy and pre- procedure analgesia effective

��No abandoned procedures ��Patient variables less

predictive

�� Staff interaction is paramount

Implication

Recommend offering patient- selected music as standard

Should be integrated into routine practice

Confirms outpatient hysteroscopy is feasible with minimal distress

Reinforces importance of modifiable, procedural factors

Human care remains central to positive patient experience