Virtual Reality Intervention in Children After Hypospadias Surgery
The Effect of Virtual Reality Headset Use on Pain, Comfort, and Psychosocial Symptoms in Children Undergoing Hypospadias Surgery: A Randomized Controlled Trial.
1 other identifier
interventional
62
1 country
1
Brief Summary
The aim of this study is to examine the effect of virtual reality glasses use on pain, comfort, and psychosocial symptoms in children after hypospadias surgery.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for not_applicable pain
Started Dec 2025
Shorter than P25 for not_applicable pain
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
December 5, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
March 1, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
June 30, 2026
CompletedFirst Submitted
Initial submission to the registry
July 22, 2026
CompletedFirst Posted
Study publicly available on registry
August 7, 2026
CompletedAugust 7, 2026
August 1, 2026
3 months
July 22, 2026
August 3, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
wong-baker faces scale
The assessment was conducted using the Wong-Baker Faces Scale. On the scale, the lowest score is "0" and the highest is "10." Pain intensity increases as the score rises. When administering the scale, an explanation is provided to the child using facial expressions, and the child is asked to select the expression that best reflects their condition. The scale scores are interpreted as follows: 0 = no pain; 2 = mild pain; 4 = some pain; 6 = distinct pain; 8 = severe pain; and 10 = unbearable pain.
1 hour after surgery/before and after application/2 times a day/10-15 minutes
pediatric comfort assessment scale
The assessment was conducted using the pediatric comfort assessment scale. It evaluates 5 parameters: sounds, motor movements, performance, facial expressions and other. Each item is evaluated on a 5-point Likert scale from 0 to 4 (0/Not Available, 1/No, 2/Somewhat, 3/Moderate, 4/Strong) from bad to good. Higher scores indicate a higher level of comfort.
1 hour after surgery/before and after application/2 times a day/10-15 minutes
Secondary Outcomes (1)
Psychosocial symptom assessment scale for hospitalized children
1 hour after surgery/before and after application/2 times a day/10-15 minutes
Study Arms (2)
control group
EXPERIMENTALroutine clinical practice
intervention group
EXPERIMENTALplaying a 15-minute game through virtual reality glasses
Interventions
One hour after the hypospadias surgery was completed and the child arrived at the ward, the children in the intervention group were fitted with Meta Quest 3 VR headsets, the procedure of which had been explained to them beforehand. The "V-SPEEDWAY" car racing game was opened through the headsets, allowing the children to play the game continuously for approximately 15 minutes. During this 15-minute VR experience, no painful medical interventions such as dressing changes or catheter insertion were performed on the child; the child was completely focused on the virtual world.
Children in the control group were not subjected to any technological or additional distracting procedures in the first hour after surgery; they only underwent routine clinical monitoring in the ward.
Eligibility Criteria
You may qualify if:
- Participants must provide written and verbal informed consent from their parents for participation in the study, and be male children aged 6-12 who have undergone hypospadias surgery.
You may not qualify if:
- Having an auditory, mental, neurological, or visual impairment/problem severe enough to prevent VR glasses use, using an additional analgesic outside of the standard protocol within the first hour after surgery, or experiencing nausea, dizziness, or excessive panic reactions related to the virtual reality glasses during the procedure.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Medipol University
Istanbul, Beykoz, 34810, Turkey (Türkiye)
Related Publications (55)
Althumairi A, Sahwan M, Alsaleh S, Alabduljobar Z, Aljabri D. Virtual Reality: Is It Helping Children Cope with Fear and Pain During Vaccination? J Multidiscip Healthc. 2021 Sep 21;14:2625-2632. doi: 10.2147/JMDH.S327349. eCollection 2021.
PMID: 34584419BACKGROUNDBhat A. General considerations in hypospadias surgery. Indian J Urol. 2008 Apr;24(2):188-94. doi: 10.4103/0970-1591.40614.
PMID: 19468396BACKGROUNDBuyuk ET, Odabasoglu E, Uzsen H, Koyun M. The effect of virtual reality on Children's anxiety, fear, and pain levels before circumcision. J Pediatr Urol. 2021 Aug;17(4):567.e1-567.e8. doi: 10.1016/j.jpurol.2021.04.008. Epub 2021 Apr 21.
PMID: 34006462BACKGROUNDChen SR, Yamaji N, Wang CH, Pan CH, Wu YL. Effects of Virtual Reality on Pain and Anxiety During Children's Circumcision: A Systematic Review and Meta-Analysis. Pain Manag Nurs. 2024 Dec;25(6):652-658. doi: 10.1016/j.pmn.2024.06.007. Epub 2024 Jul 10.
PMID: 38991908BACKGROUNDComparcini D, Simonetti V, Galli F, Saltarella I, Altamura C, Tomietto M, Desaphy JF, Cicolini G. Immersive and Non-Immersive Virtual Reality for Pain and Anxiety Management in Pediatric Patients with Hematological or Solid Cancer: A Systematic Review. Cancers (Basel). 2023 Feb 3;15(3):985. doi: 10.3390/cancers15030985.
PMID: 36765945BACKGROUNDEuropean Association of Urology. (2026). Paediatric urology guidelines: Hypospadias. EAU Guidelines Office. Retrieved July 3, 2026, from https://uroweb.org/guidelines/paediatric-urology/chapter/hypospadias
BACKGROUNDFauzan R, Wahyudi I, Reinaldi Situmorang G, Rodjani A, Angga Risky Raharja P. Psychological Outcomes After Hypospadias Repair: Does Age at Surgery Matter? A Systematic Review. Cureus. 2026 May 31;18(5):e109964. doi: 10.7759/cureus.109964. eCollection 2026 May.
PMID: 42338833BACKGROUNDFortier MA, Del Rosario AM, Rosenbaum A, Kain ZN. Beyond pain: predictors of postoperative maladaptive behavior change in children. Paediatr Anaesth. 2010 May;20(5):445-53. doi: 10.1111/j.1460-9592.2010.03281.x. Epub 2010 Feb 23.
PMID: 20199608BACKGROUNDGültekin, M., (2019). Evaluation of the effect of distraction methods used in blood sampling on pain and anxiety in children. (Thesis No. 565770) [Master's Thesis, Balıkesir University] YÖK National Thesis Center.
BACKGROUNDHayaran N, Kaushik P, Yadav S, Hage A. A Prospective Observational Study Analyzing the Analgesic Efficacy of Caudal Block and Nerve Stimulator-Guided Pudendal Nerve Block in Children Undergoing Hypospadias Repair. Cureus. 2023 Sep 4;15(9):e44649. doi: 10.7759/cureus.44649. eCollection 2023 Sep.
PMID: 37671076BACKGROUNDHayashi Y, Kojima Y. Current concepts in hypospadias surgery. Int J Urol. 2008 Aug;15(8):651-64. doi: 10.1111/j.1442-2042.2008.02081.x. Epub 2008 Jun 3.
PMID: 18522675BACKGROUNDHess CW, Rosenbloom BN, Mesaroli G, Lopez C, Ngo N, Cohen E, Ouellette C, Gold JI, Logan D, Simons LE, Stinson JN. Extended Reality (XR) in Pediatric Acute and Chronic Pain: Systematic Review and Evidence Gap Map. JMIR Pediatr Parent. 2025 Apr 7;8:e63854. doi: 10.2196/63854.
PMID: 40194270BACKGROUNDInan G, Inal S. The Impact of 3 Different Distraction Techniques on the Pain and Anxiety Levels of Children During Venipuncture: A Clinical Trial. Clin J Pain. 2019 Feb;35(2):140-147. doi: 10.1097/AJP.0000000000000666.
PMID: 30362982BACKGROUNDİnal, S., & Canbulat, N. (2015). Use of distraction techniques in procedural pain management in children. Journal of Health Sciences in Nursing (HSP), 2(3), 372-378.
BACKGROUNDKahraman Kılbaş, E. P., & Cevahir, F. (2023). Sampling Selection and Power Analysis in Scientific Research. Journal of Biotechnology and Strategic Health Research, 7(1), 1-8. https://doi.org/10.34084/bshr.1217279
BACKGROUNDKaimara P, Oikonomou A, Deliyannis I. Could virtual reality applications pose real risks to children and adolescents? A systematic review of ethical issues and concerns. Virtual Real. 2022;26(2):697-735. doi: 10.1007/s10055-021-00563-w. Epub 2021 Aug 3.
PMID: 34366688BACKGROUNDKaya M, Karaman Ozlu Z. The effect of virtual reality on pain, anxiety, and fear during burn dressing in children: A randomized controlled study. Burns. 2023 Jun;49(4):788-796. doi: 10.1016/j.burns.2022.06.001. Epub 2022 Jun 9.
PMID: 35753857BACKGROUNDKhajar, F. N., Tariq, S., Ahmed, A. M., Afzal, Y., Shaikh, T. G., Nashwan, A. J., & Ullah, I. (2023). Virtual reality for pain and anxiety management in children undergoing venipuncture procedures: A systematic review and meta-analysis. Global Pediatrics, 4, 100060.
BACKGROUNDKilic U, Tural Buyuk E. The Effect of Using Virtual Reality During Burn Dressing on Pain, Anxiety and Fear Felt in Children: A Randomized Controlled Trial. J Burn Care Res. 2024 Aug 6;45(4):949-957. doi: 10.1093/jbcr/irae005.
PMID: 38224569BACKGROUNDKolcaba K, DiMarco MA. Comfort Theory and its application to pediatric nursing. Pediatr Nurs. 2005 May-Jun;31(3):187-94.
PMID: 16060582BACKGROUNDKolcaba K, Wilson L. Comfort care: a framework for perianesthesia nursing. J Perianesth Nurs. 2002 Apr;17(2):102-11; quiz 111-3. doi: 10.1053/jpan.2002.31657.
PMID: 11925582BACKGROUNDKökcü Doğan, A., Avcı, Ö., & Kuğuoğlu, S. (2025). Turkish validity and reliability study of the Pediatric Comfort Assessment Scale. Ege University Faculty of Nursing Journal, 41(1), 136-146. https://doi.org/10.53490/egehemsire.1260623
BACKGROUNDKurban, B., & Konuk Şener, D. (2024). The effect of virtual reality glasses on pain and anxiety levels during vaccine injection in children aged 6-12 years: Randomized controlled trial. Journal of Health Academics, 11(1), 108-117. https://doi.org/10.52880/sagakaderg.1377204
BACKGROUNDLeroy PL, Dickens R, Zirar-Vroegindeweij A, Mendels E. [Procedural comfort care in pediatric healthcare: bringing children from fear to trust]. Ned Tijdschr Geneeskd. 2026 Mar 3;170:D8711. Dutch.
PMID: 41784282BACKGROUNDLi J, Fan X, Deng Q, Sun J, Jin L, Chen P, Wei P, Liu A. Significance of Continuous Nursing of Omaha System in Children after Hypospadias Surgery and Its Influence on Infection Complications. Contrast Media Mol Imaging. 2022 Sep 1;2022:8346848. doi: 10.1155/2022/8346848. eCollection 2022.
PMID: 36105447BACKGROUNDLi WH, Chung JO, Ho EK. The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer. J Clin Nurs. 2011 Aug;20(15-16):2135-43. doi: 10.1111/j.1365-2702.2011.03733.x. Epub 2011 Jun 8.
PMID: 21651633BACKGROUNDLiszio S, Bauerlein F, Hildebrand J, van Nahl C, Masuch M, Basu O. Cooperative Virtual Reality Gaming for Anxiety and Pain Reduction in Pediatric Patients and Their Caregivers During Painful Medical Procedures: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2025 Mar 31;14:e63098. doi: 10.2196/63098.
PMID: 40164171BACKGROUNDLitwin SP, Nguyen C, Hundert A, Stuart S, Liu D, Maguire B, Matava C, Stinson J. Virtual Reality to Reduce Procedural Pain During IV Insertion in the Pediatric Emergency Department: A Pilot Randomized Controlled Trial. Clin J Pain. 2021 Feb 1;37(2):94-101. doi: 10.1097/AJP.0000000000000894.
PMID: 33177370BACKGROUNDLuo R, Zuo Y, Liu HB, Pan Y. Postoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study. Paediatr Anaesth. 2019 Feb;29(2):144-152. doi: 10.1111/pan.13539. Epub 2018 Dec 23.
PMID: 30365242BACKGROUNDMallari B, Spaeth EK, Goh H, Boyd BS. Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis. J Pain Res. 2019 Jul 3;12:2053-2085. doi: 10.2147/JPR.S200498. eCollection 2019.
PMID: 31308733BACKGROUNDMeulenkamp-Yilmaz L, El Bardai S, Hillegers MHJ, Legerstee J, Dierckx B, Staals L. The Analgesic Effect of Extended Reality (XR) on Acute and Postoperative Pain in Children: A Systematic Review and Meta-Analysis. Paediatr Anaesth. 2026 May;36(5):479-490. doi: 10.1002/pan.70157. Epub 2026 Mar 7.
PMID: 41795162BACKGROUNDNiyonkuru E, Iqbal MA, Zhang X, Ma P. Complementary Approaches to Postoperative Pain Management: A Review of Non-pharmacological Interventions. Pain Ther. 2025 Feb;14(1):121-144. doi: 10.1007/s40122-024-00688-1. Epub 2024 Dec 17.
PMID: 39681763BACKGROUNDOkay B, Uze Okay Z. Investigating the effect of virtual reality glasses during inhaler therapy use in children: A randomized clinical trial. Paediatr Child Health. 2024 May 29;30(1):11-16. doi: 10.1093/pch/pxae020. eCollection 2025 Feb.
PMID: 40061246BACKGROUNDOktavia Karundeng, J., Nurhaeni, N., & Wanda, D. (2022). Application of Kolcaba theory in child patients with pain problems in the infection room. Journal of Ners Community, 13(4), 403-409. https://doi.org/10.55129/jnerscommunity.v13i4.1966
BACKGROUNDOlbrecht VA, O'Conor KT, Williams SE, Boehmer CO, Marchant GW, Glynn SM, Geisler KJ, Pickerill HM, Ding L, Yang G, King CD. Transient Reductions in Postoperative Pain and Anxiety with the Use of Virtual Reality in Children. Pain Med. 2021 Nov 26;22(11):2426-2435. doi: 10.1093/pm/pnab209.
PMID: 34175959BACKGROUNDOlson, C. K. (2010). Children's motivations for video game play in the context of normal development. Review of General Psychology, 14(2), 180-187.
BACKGROUNDPfeil, M., Parr, J., Kulkarni, M., & Mathur, A. B. (2012). Hypospadias repair: The nursing contribution. International Journal of Urological Nursing, 6, 152-158. https://doi.org/10.1111/j.1749-771X.2012.01152.x
BACKGROUNDRath, A., & Reena. (2022). Role of pudendal nerve block for prevention of catheter-related bladder discomfort in male pediatric patients undergoing hypospadias surgery: A prospective randomized control study. Ain-Shams Journal of Anesthesiology, 14, 40. https://doi.org/10.1186/s42077-022-00233-2
BACKGROUNDSavas EH, Demir AS, Semerci R, Karadag A. Effect of virtual reality on pain during burn dressing in children: A systematic review and meta-analysis of randomized controlled trials. J Pediatr Nurs. 2023 Nov-Dec;73:e364-e371. doi: 10.1016/j.pedn.2023.10.002. Epub 2023 Oct 7.
PMID: 37806856BACKGROUNDSanchez-Lopez MI, Lluesma-Vidal M, Ruiz-Zaldibar C, Tomas-Saura I, Martinez-Fleta MI, Gutierrez-Alonso G, Garcia-Garces L. The effect of virtual reality versus standard-of-care treatment on pain perception during paediatric vaccination: A randomised controlled trial. J Clin Nurs. 2025 Mar;34(3):1045-1062. doi: 10.1111/jocn.17287. Epub 2024 Jun 14.
PMID: 38873883BACKGROUNDSilva, K., Breeland, N., Clark, A.M., Öztekin, I., Kelly, R.L. (2025). Effects of virtual reality use in children aged 10 to 12 years. Front. Virtual Real. 6:1547198. doi: 10.3389/frvir.2025.1547198
BACKGROUNDSpecht BJ, Buse CR, Phelps JR, Phillips MR, Chiavacci SD, Harrell LE, Nelson JM, Poulos KE, Li Q, Liu Y, Lupa MC. Virtual Reality after Surgery-A Method to Decrease Pain After Surgery in Pediatric Patients. Am Surg. 2023 Apr;89(4):596-602. doi: 10.1177/00031348211032204. Epub 2021 Jul 17.
PMID: 34275343BACKGROUNDStangl-Kremser J, Olivera L, Giudici S, Pradere B, Mertens LS, Albisinni S, Laukhtina E, Del Giudice F, Afferi L, Soria F, Sforza S, O'Kelly F, Lammers RJ, Silay MS, Minervini A, Masieri L, Akhavan A, 't Hoen LA, Moschini M, Mari A; European Association of Urology - Young Academic Urologists (EAU-YAU): Urothelial Carcinoma Working Group and Pediatric Urology Group. Application of the ERAS guidelines in pediatric urological surgery: a systematic review. Minerva Urol Nephrol. 2024 Jun;76(3):271-277. doi: 10.23736/S2724-6051.24.05511-3.
PMID: 38920008BACKGROUNDTas FQ, van Eijk CAM, Staals LM, Legerstee JS, Dierckx B. Virtual reality in pediatrics, effects on pain and anxiety: A systematic review and meta-analysis update. Paediatr Anaesth. 2022 Dec;32(12):1292-1304. doi: 10.1111/pan.14546. Epub 2022 Sep 1.
PMID: 35993398BACKGROUNDTeh JJ, Pascoe DJ, Hafeji S, Parchure R, Koczoski A, Rimmer MP, Khan KS, Al Wattar BH. Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis. BMC Med. 2024 Feb 14;22(1):64. doi: 10.1186/s12916-024-03266-6.
PMID: 38355563BACKGROUNDTychsen L, Foeller P. Effects of Immersive Virtual Reality Headset Viewing on Young Children: Visuomotor Function, Postural Stability, and Motion Sickness. Am J Ophthalmol. 2020 Jan;209:151-159. doi: 10.1016/j.ajo.2019.07.020. Epub 2019 Aug 1.
PMID: 31377280BACKGROUNDUcgun T, Citak EA. Virtual reality for cancer symptom management: a systematic review of randomized controlled trials. Support Care Cancer. 2025 Jul 9;33(8):672. doi: 10.1007/s00520-025-09738-6.
PMID: 40632238BACKGROUNDÜstün, G., & Kelleci, M. (2013). Assessment scale for psychosocial symptoms in hospitalized children: Scale development, reliability and validity study. HealthMED, 7(7), 2219-2228
BACKGROUNDWong-Baker FACES Foundation. (n.d.). History of the Wong-Baker FACES® Pain Rating Scale. Retrieved January 6, 2026, from https://wongbakerfaces.org/us/wong-baker-faces-history/
BACKGROUNDWong CL, Choi KC. Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture: A Randomized Clinical Trial. JAMA Netw Open. 2023 Feb 1;6(2):e230001. doi: 10.1001/jamanetworkopen.2023.0001.
PMID: 36795410BACKGROUNDXiang H, Shen J, Wheeler KK, Patterson J, Lever K, Armstrong M, Shi J, Thakkar RK, Groner JI, Noffsinger D, Giles SA, Fabia RB. Efficacy of Smartphone Active and Passive Virtual Reality Distraction vs Standard Care on Burn Pain Among Pediatric Patients: A Randomized Clinical Trial. JAMA Netw Open. 2021 Jun 1;4(6):e2112082. doi: 10.1001/jamanetworkopen.2021.12082.
PMID: 34152420BACKGROUNDXie S, Yin F, Wang M, Wang F, Zhu Y, Zhao Y, Qiu Y, Chen X, Yang Y. Dynamic assessment of pain, fear, and physiological stress during pediatric intravenous cannulation: a randomized controlled trial of virtual reality distraction. BMC Nurs. 2026 Jun 19. doi: 10.1186/s12912-026-04906-3. Online ahead of print.
PMID: 42321747BACKGROUNDYuki K, Daaboul DG. Postoperative maladaptive behavioral changes in children. Middle East J Anaesthesiol. 2011 Jun;21(2):183-9.
PMID: 22435270BACKGROUNDZainal Abidin H, Omar SC, Mazlan MZ, Hassan MH, Isa R, Ali S, Hassan SK, Marzuki A. Postoperative Maladaptive Behavior, Preoperative Anxiety and Emergence Delirium in Children Undergone General Anesthesia: A Narrative Review. Glob Pediatr Health. 2021 Apr 7;8:2333794X211007975. doi: 10.1177/2333794X211007975. eCollection 2021.
PMID: 33889680BACKGROUNDZavlanou C, Savary V, Mermet S, Sander D, Corradi-Dell'Acqua C, Rudrauf D, Tisserand Y, Sahyoun C. Virtual reality vs. tablet for procedural comfort using an identical game in children undergoing venipuncture: a randomized clinical trial. Front Pediatr. 2024 May 13;12:1378459. doi: 10.3389/fped.2024.1378459. eCollection 2024.
PMID: 38803637BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- STUDY DIRECTOR
Aysel Kokcu Dogan
Faculty Member
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- INVESTIGATOR
- Purpose
- SUPPORTIVE CARE
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Ph.D., Asst. Prof.
Study Record Dates
First Submitted
July 22, 2026
First Posted
August 7, 2026
Study Start
December 5, 2025
Primary Completion
March 1, 2026
Study Completion
June 30, 2026
Last Updated
August 7, 2026
Record last verified: 2026-08
Data Sharing
- IPD Sharing
- Will not share