Music Intervention During AEEP: A Prospective Randomized Controlled Trial

Benign prostatic hyperplasia (BPH) is one of the most common urological conditions in aging men, often requiring surgical intervention when medical therapy fails. Anatomical Endoscopic Enucleation of the Prostate (AEEP) has emerged as an effective and tissue-preserving surgical approach for managing BPH. Despite the minimally invasive nature of AEEP, perioperative anxiety and postoperative pain remain important determinants of patient comfort, satisfaction, and overall recovery.

Music listening is a simple, inexpensive, and non-pharmacological behavioral intervention that has been shown in various surgical disciplines to reduce anxiety, modulate pain perception, and improve patient experience. However, its potential benefits during AEEP have not been previously explored.

In this prospective randomized controlled trial, we evaluated the effect of perioperative music exposure on anxiety and acute postoperative pain among patients undergoing AEEP. A total of 135 male patients scheduled for AEEP were enrolled and randomized into two groups:

Music Group (n = 67): Patients listened to standardized relaxing instrumental music via headphones starting immediately before anesthesia induction and continuing during the procedure.

Control Group (n = 68): Patients received routine perioperative care without exposure to music.

Perioperative anxiety was measured using the State Anxiety Inventory (SAI) at two predefined time points: immediately before surgery and at the postoperative 2nd hour. Postoperative pain intensity was assessed using the Visual Analog Scale (VAS) 2 hours after the procedure. All surgical and anesthetic techniques were standardized across groups to minimize variability.

This study aims to determine whether perioperative music listening can serve as an effective adjunctive intervention to improve psychological well-being and reduce pain in patients undergoing AEEP. Findings from this research may support the integration of music into perioperative care pathways, offering a safe and easily applicable strategy to enhance patient-centered outcomes in endoscopic prostate surgery.

Inclusion criteria

• male patients aged ≥40 years
• patients who underwent surgery under regional anesthesia without sedation
• patients who did not benefit from medical treatment for BPO
• preoperative International Prostate Symptom Score (IPSS) >19
• preoperative maximum urine flow rate (Qmax) <15 mL/sec
• post-voiding residual volume (PVR) >50 mL.

Exclusion criteria

• patients with urethral stricture
• patients who underwent urological treatments other than laser enucleation of the prostate
• patients with urinary tract infections and/or hematuria
• patients with urinary system malignancy
• patients with a history of previous prostate surgery
• patients with neurogenic bladder
• patients with hearing impairment
• patients with psychiatric disorders or those using medications prescribed by a psychiatrist.