Evidence map›Paper›PMID 41821023›Full record

Trial reportBMC women's health2026

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

Zoë Boersen, Joukje Marije Oosterman, Frederik Paul Hendrick Louis Jacob Dijkhuizen, Hubertus Antonius Augustinus Maria van Vliet, Jan Willem van der Steeg, Gijs Teklenburg, Heidi Sabine Mathilde Jeanne Delcliseur, Esther Gerdien Winter, Kyra Alicia IJssel de Schepper, Diderika Dorothea Maria Dorothea and 2 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04448366 (Cognitive Behavioral Therapy to Improve Quality of Life After Surgical Treatment of Women With Endometriosis), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04448366 nacompletednot on this map

Cognitive Behavioral Therapy to Improve Quality of Life After Surgical Treatment of Women With Endometriosis

TypeinterventionalSponsorRijnstate HospitalRan2020 to 2024Enrolled100ConditionsEndometriosis, Quality of Life, PainArmsCognitive behavioral therapy
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Zoë BoersenDepartment of Obstetrics and Gynaecology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, Gelderland, 6815 AD, The Netherlands.
Joukje Marije OostermanDonders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, Nijmegen, Gelderland, 6525 EN, The Netherlands.
Frederik Paul Hendrick Louis Jacob DijkhuizenDepartment of Obstetrics and Gynaecology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, Gelderland, 6815 AD, The Netherlands.
Hubertus Antonius Augustinus Maria van VlietDepartment of Obstetrics and Gynaecology, Catharina Hospital, Michelangelolaan 2, Eindhoven, Noord-Brabant, 5623 EJ, The Netherlands.
Jan Willem van der SteegDepartment of Obstetrics and Gynaecology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, Noord-Brabant, The Netherlands.
Gijs TeklenburgDepartment of Obstetrics and Gynaecology, Isala Hospital, Dokter van Heesweg 2, Zwolle, Overijssel, 8025 AB, The Netherlands.
Heidi Sabine Mathilde Jeanne DelcliseurDepartment of Medical Psychology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, Gelderland, 6815 AD, The Netherlands.
Esther Gerdien WinterDepartment of Medical Psychology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, Gelderland, 6815 AD, The Netherlands.
Kyra Alicia IJssel de SchepperDepartment of Medical Psychology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, Gelderland, 6525 GA, The Netherlands.
Diderika Dorothea Maria DorotheaDepartment of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, Gelderland, 6525 GA, The Netherlands.
Christianne Maria VerhaakDepartment of Medical Psychology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, Gelderland, 6525 GA, The Netherlands.
Anna Willemina NapDepartment of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, Gelderland, 6525 GA, The Netherlands. Annemiek.nap@radboudumc.nl.

Funding

Radboudumc-Rijnstate PhD funding W.000003.1
6 · The paper itself

Abstract

research questionEndometriosis-related chronic pain leads to impaired health-related quality of life (HRQoL). Endometriosis surgery can improve chronic pain and HRQoL, however, pain complaints often remain and HRQoL is still lower compared to that in healthy women. Cognitive behavioral therapy (CBT) is promising for the treatment of chronic pain. In this study we evaluate the effect of CBT on HRQoL in patients undergoing surgery for endometriosis-related chronic pain.

designThis randomized controlled, single-blind multicenter, clinical trial, 100 Dutch patients undergoing surgery for endometriosis related chronic pain were included. Participants were randomized between endometriosis surgery only or endometriosis surgery plus seven sessions of CBT. Questionnaires evaluated HRQoL, pain intensity, catastrophizing, anxiety, fatigue, and perceived stress four weeks prior to surgery (T0), and two (T1) and 16 (T2) weeks after the final CBT session. Hair cortisol concentrations (HCC) were analyzed to measure chronic stress. Group differences were evaluated with linear mixed models.

resultsInclusion occurred between November 24, 2020 and December 28, 2023. The intention to treat analysis included 100 patients, 50 in each group. In the CBT group, the Endometriosis Health Profile (EHP)-30 modular part (p=0.021) and the Short Form (SF)-36 physical component scale (p=0.008) improved more when compared to the surgery-only group. Pain catastrophizing (p=0.019), and anxiety (p=0.047) were significantly lower in patients who were in the CBT group. In contrast, HCC (p=0.022) was significantly higher in the CBT group. The EHP-30 core part, SF-36 mental component scale, pain intensity, fatigue, and perceived stress did not show a significant overall improvement.

conclusionsCBT can improve HRQoL in patients surgically treated for endometriosis-related chronic pain. The reduction of pain catastrophizing was a major factor in this effect. TRIAL REGISTER: ClinicalTrials.gov NCT04448366. Registered on June 3th, 2020. First participant enrollment: 24-11-2020. https://clinicaltrials.gov/study/NCT04448366?cond=NCT04448366&rank=1. The data generated and analyzed during the current study are available at Radboud Data Repository. The data can be accessed via https://doi.org/10.34973/fqsc-wd42. Data will be available for academic and non-commercial purposes upon reasonable request, starting one year after publication date.Trial register.

Indexed as

Chronic PainCognitive Behavioral TherapyEndometriosisQuality of LifeAdultAnxietyCatastrophizationFemaleHumansNetherlandsSingle-Blind MethodStress, PsychologicalSurveys and QuestionnairesCatastrophizing, cognitive behavioral therapyChronic painEndometriosisHealth related quality of lifeSurgery

Identifiers

PMID41821023
PMCPMC13094018

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.