Virtual reality may enhance consenting process for shock wave lithotripsy

Virtual reality (VR)–based education during the consent process for shock wave lithotripsy (SWL) was associated with improved patient understanding, greater confidence, and reduced pre-procedural anxiety, according to findings presented at the 41st Annual Congress of the European Association of Urology (EAU) in London, UK.¹

The prospective study also suggested a potential association between VR exposure and lower post-procedural pain scores, raising questions about broader perioperative benefits.

“There is currently a mismatch between the complexity of information provided to patients and the level which most people can comprehend. This risks people consenting to procedures they don’t fully understand,” explained presenting author Solomon Bracey, a medical student at the University of Southampton, in a news release on the findings.² “VR has been shown to improve learning and knowledge retention, and our study suggests it could be used to help people to make more fully informed decisions about their health. We were also encouraged by what we saw in pain questionnaires, which gives us an important question to explore in future research.”

The single-center, prospective study enrolled 150 patients aged 22 to 80 years at University Hospital Southampton who were scheduled to undergo SWL as part of routine care. Participants engaged with a 3-minute VR animation designed according to British and European urolithiasis guidelines, which visually demonstrated renal anatomy, the mechanics of shock wave delivery, and associated risks and benefits.

In the study, the VR platform allowed patients to “stand” in a virtual operating room and observe SWL in real time, including a zoomed-in view of shock wave interaction with renal calculi. The system also enabled movement within the virtual space, offering multiple perspectives on anatomy and instrumentation.

Patients completed questionnaires before and after the VR experience assessing understanding, emotional state, and perceived accessibility of educational materials. Pain scores were also collected following SWL and compared with previously published SWL cohorts.

Quantitatively, VR outperformed standard written materials across all assessed educational domains. Mean ratings (on a 1 to 4 scale) significantly favored VR for understanding of lithotripsy (3.72 vs 2.76), helpfulness of resources (3.73 vs 3.14), confidence in explaining the procedure (3.63 vs 3.03), and accessibility (3.77 vs 3.17). VR exposure was also associated with lower pre-procedural nervousness (1.66 vs 1.91). These benefits were more pronounced in the oldest group of patients, aged 65 and above. No differences were noted between male and female patients.

Reported post-procedural pain scores averaged 2.17, which investigators described as lower than those reported in prior SWL studies, though no direct comparator arm was included.

Among all participants, 88% indicated a strong preference for including VR in future treatment.

“The use of VR is an exciting idea that could enhance the patient experience during the consent process,” commented Matthew Bultitude, MBBS, MRCS, MSc, FRCS(Urol), a consultant urological surgeon and member of the EAU Scientific Congress Office.² “Technology should never replace a conversation with a clinician, where patients have a chance to ask detailed questions, but it could help to level the playing field in terms of health literacy, so that everyone comes into that discussion with the same baseline level of information.”

Looking ahead, the investigators indicated interest in further examining whether VR-based education could help reduce pain for patients undergoing SWL.

REFERENCES

1. Bracey S, Bamerni D, Tear L, et al. Exploring the impact of virtual reality to improve the consent process and provide counselling for patients undergoing shock wave lithotripsy. Presented at: 41st Annual Congress of the European Association of Urology. March 13-16, 2026. London, UK. Abstract P0251

2. Press release: VR could reduce anxiety for people undergoing medical procedures. News release. European Association of Urology. March 13, 2026. Accessed April 8, 2026. https://uroweb.org/news/vr-could-reduce-anxiety-for-people-undergoing-medical-procedures