To evaluate whether exposure to different metronome rhythms is associated with variations in patient-reported pain intensity and anxiety levels during transperineal prostate biopsy performed under local anesthesia.

This single-center, prospective, non-randomized study included 200 patients undergoing TPBx. Patients were assigned according to routine clinical workflow to a control group or metronome rhythm groups at 60, 80, 100, or 120 bpm. Pain was assessed using the Visual Analog Scale, and anxiety was evaluated using the State-Trait Anxiety Inventory. The primary outcome was overall procedural pain.

Final analysis included 196 patients. Overall pain scores and pain during local anesthetic administration differed significantly among groups ( P < .001). The lowest pain scores were observed in the 100 bpm group. Post-procedural anxiety scores were significantly lower in the 60-100 bpm groups compared with the control and 120 bpm groups. Baseline characteristics were comparable.

Metronome rhythm-based auditory stimulation was associated with differences in pain and anxiety during TPBx and may represent a simple adjunct to improve patient experience.