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      Virtual Reality Therapy as an Adjunct to Physiotherapy for Postoperative Pain Management: A Case Report of Laparoscopic Open Pyeloplasty for Hydronephrosis

      case-report

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          Abstract

          Hydronephrosis occurs when the tubes connecting the kidneys and bladder become blocked. These tubes carry urine from the kidneys, where it is created, to the bladder, where it is stored until elimination. When one or both ureters get blocked, serious complications and symptoms might arise. These symptoms include urinary tract obstruction, urine backflow, kidney distension, increased intra-renal pressure, impaired kidney function, infection risk, urinary incontinence, which is the involuntary loss of urine, and discomfort in the side, abdomen, or groin. This case report describes the effective postoperative management of abdominal surgery with virtual reality therapy (VRT) combined with standard medical care as additional therapy and physical therapy for hydronephrosis in a 22-year-old male patient. After undergoing laparoscopic open pyeloplasty, the patient developed right-sided hydronephrosis due to ureteral stenosis. He had a ureteral stent inserted and received physical therapy, including pelvic floor muscle training, core strengthening, and diaphragmatic breathing exercises. After four weeks of physical therapy, the patient reported improvement in his symptoms, including reduced discomfort and increased urination. These findings imply that physical therapy, in addition to advanced treatment with the help of VRT for hydronephrosis following abdominal surgery, might be beneficial.

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          Reducing anxiety in preoperative patients: a systematic review.

          There are still uncertainties regarding the appropriateness and effectiveness of various modes of delivering preoperative education. Hence, this systematic review was conducted to investigate the effectiveness of various preoperative educational interventions in reducing preoperative anxiety. Fourteen interventional trials (12 randomised controlled trials and two pre/post test trials) involving a total of 1752 participants were included in the review. Four studies used audiovisual; two trials used visual; two trials used multimedia-supported education; one trial used a website; two trials involved verbal education delivered by a psychologist or a nurse facilitator coupled with leaflets; and one trial involved informational leaflets only. Eight of the 14 trials demonstrated that preoperative education intervention reduced preoperative anxiety significantly (P<0.05). It can be concluded that preoperative education interventions are promising in reducing preoperative anxiety in patients scheduled for surgical procedures.
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            Virtual Reality Therapy in Mental Health

            Initially designed for the treatment of phobias, the use of virtual reality in phobic disorders has expanded to other mental health disorders such as posttraumatic stress disorder, substance-related disorders, eating disorders, psychosis, and autism spectrum disorder. The goal of this review is to provide an accessible understanding of why this approach is important for future practice, given its potential to provide clinically relevant information associated with the assessment and treatment of people suffering from mental illness. Most of the evidence is available for the use of virtual reality exposure therapy in anxiety disorders and posttraumatic stress disorder. There is hardly any evidence that virtual reality therapy is effective in generalized anxiety disorder and obsessive-compulsive disorder. There is increasing evidence that cue exposure therapy is effective in addiction and eating disorders. Studies into the use of virtual reality therapy in psychosis, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD) are promising.
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              Hand-Held Ultrasound Devices Compared with High-End Ultrasound Systems: A Systematic Review

              The aim of this study was to review the scientific literature available on the comparison of hand-held ultrasound devices with high-end systems for abdominal and pleural applications. PubMed, Embase, Web of Science and Cochrane were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original research describing hand-held ultrasound devices compared with high-end systems was included and assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2. The search was limited to articles published since 1 January 2012. A total of 2486 articles were found and screened by title and abstract. A total of 16 articles were chosen for final review. All of the included articles showed good overall agreement between hand-held and high-end ultrasound systems. Strong correlations were found when evaluating ascites, hydronephrosis, pleural cavities, in detection of abdominal aortic aneurysms and for use with obstetric and gynaecological patients. Other articles found good agreement for cholelithiasis and for determining the best site for paracentesis. QUADAS-2 analysis suggested few risks of bias and almost no concerns regarding applicability. For distinct clinical questions, hand-held devices may be a valuable supplement to physical examination. However, evidence is inadequate, and more research is needed on the abdominal and pleural use of hand-held ultrasound with more standardised comparisons, using only blinded reviewers.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                4 November 2023
                November 2023
                : 15
                : 11
                : e48254
                Affiliations
                [1 ] Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
                Author notes
                Article
                10.7759/cureus.48254
                10694782
                38054124
                5e3e7601-a474-4057-a2f9-d364ce6ed5be
                Copyright © 2023, Puri et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 24 June 2023
                : 4 November 2023
                Categories
                Physical Medicine & Rehabilitation

                virtual reality-based rehabilitation,patient outcomes,pain management,breathing exercises,postoperative care,rehabilitation,hydronephrosis,abdominal surgery,physiotherapy

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