INTRODUCTION AND OBJECTIVES: Trans Urethral Resection ofBladder Tumor (TUR-BT) is one of the most commonly performed procedures by urologists. This procedure is usually accompanied by anxiety of the patients and can result in physiologic response similar to anxiety disorder. Such event can affect the course of anesthesia, surgery and recovery. Standard of care (SOC) treatment for reducing anxiety include anxiolytic agents.In recent years the use of complementary and alternative medicine (CAM) is increasing steadily across the world, particularly in oncologic patients undergoing interventional procedures. Literature search revealed only very few publications concerning CAM in patients with urothelial cell carcinoma. In the current study we evaluated the use CAM (acupuncture) for reducing the preoperative anxiety of patients undergoing TUR-BT.METHODS: We conducted a prospective randomized control trial. Patients referred for TUR-BT based on clinical and imaging findings suggestive of bladder wall lesion were enrolled and divided into two groups: acupuncture þ SOC treatment and SOC treatment. Upon arrival to the induction room patients in both groups completed an anxiety VAS questionnaire. Patients in the intervention group received acupuncture treatment for the duration of 15-30 minutes at the induction room. Patients were asked to fill out the VAS anxiety questionnaire before and 15 minutes after intervention. Patients were also asked regarding their expectations from the treatment.RESULTS: 118 patients were included in the final analysis. Mean VAS anxiety score before treatment for the entire population was 4.25 without difference between the groups (p[0.28). After treatment, significant decrease of anxiety level in acupuncture group, mean difference of 2.64 points, in contrast to the control group in which we observed increase in the vas score of 0.6 points (p<0.001). In subgroup analysis of patients with baseline significant anxiety level (VAS > 4) we observed even more pronounced effect. While the score of anxiety in the SOC group increased from 6.00 to 6.48 points, it significantly decreased in the intervention group from 6.35 to 2.56 (P<0.001). No difference was noted between study groups when patients were asked about their expectations from the treatment (p[0.699). Concerning toxicity, except for occasional mild discomfort at the puncture site no adverse events were recorded CONCLUSIONS: We present a unique study that demonstrate the advantage of acupuncture in reducing anxiety in patients undergoing TUR-BT
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