Aromatherapy Effects on Pain and Anxiety During Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial

BACKGROUND AND PURPOSE: This study aimed to evaluate the effects of lavender and frankincense aromatherapy on anxiety and pain during transrectal ultrasound-guided prostate biopsy. MATERIALS AND METHODS: In this randomized, double-blind, placebo-controlled trial, 120 male patients scheduled for prostate biopsy at a tertiary care center were enrolled. Participants were randomly assigned to receive placebo (n = 40), lavender aromatherapy (n = 41), or frankincense aromatherapy (n = 39) administered via nebulizer during the procedure. Primary outcomes included changes in anxiety levels, measured pre- and post-procedure using the State Anxiety Inventory (STAI-I), and pain intensity assessed using the Visual Analog Scale (VAS). All participants received standard periprostatic local anesthesia. RESULTS: Both aromatherapy interventions significantly reduced anxiety with large effect sizes. The lavender group demonstrated a mean reduction of 7.39 ± 7.12 points (p < 0.001; Cohen's d = -1.090), while the frankincense group demonstrated a reduction of 8.54 ± 9.98 points (p < 0.001, Cohen's d = -1.102). In contrast, the control group showed no significant change (-0.82 ± 4.41 points, p = 0.099; Cohen's d = -0.107). Both intervention groups also showed significant analgesic effects, with actual pain scores lower than anticipated pain levels (p < 0.001 for both comparisons). No adverse events were reported. CONCLUSION: Lavender and frankincense aromatherapy significantly reduced anxiety and pain during prostate biopsy, with clinically meaningful improvements in STAI-I and VAS scores and no observed safety concerns. These findings support the use of aromatherapy as a practical adjunct to standard care in urological procedures, contributing to improved patient-centered outcomes.