Improving health-related quality of life in patients with endometriosis-related chronic pain: The COGENS trial

The COGENS trial evaluated whether adding cognitive behavioral therapy (CBT) to endometriosis surgery improves health-related quality of life (HRQoL) in 100 Dutch patients undergoing surgery for endometriosis-related chronic pain, compared with surgery alone. HRQoL and related outcomes (pain intensity, catastrophizing, anxiety, fatigue, perceived stress) were measured before surgery (T0) and at 2 and 16 weeks after the final CBT session (T1, T2), and hair cortisol concentrations were analyzed as a marker of chronic stress; group differences were assessed with linear mixed models. The intention-to-treat analysis found greater improvements in the CBT group versus surgery-only for EHP-30 modular and SF-36 physical component scores, as well as lower pain catastrophizing and anxiety; other outcomes and hair cortisol were also assessed (with no additional significant CBT-specific results stated in the abstract). This preprint is not yet peer reviewed, and the study enrolled participants between 2020 and 2023 with outcomes focused on relatively short follow-up after CBT. This paper is centrally about endometriosis — it tests whether CBT added to surgery improves HRQoL and associated psychological factors in patients with endometriosis-related chronic pain.

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