Use of pre-operative GnRH-analogue to predict pain outcome following hysterectomy with or without oophorectomies for chronic pelvic pain.

This study investigates whether pre-operative use of gonadotrophin-releasing hormone analogues (GnRHa), which induce a hypo-estrogenic state mimicking surgical menopause, can predict pain outcomes in patients undergoing hysterectomy and/or oophorectomies for chronic pelvic pain (CPP). In a retrospective cohort of 56 patients treated at a tertiary university-affiliated hospital, a positive pain response to GnRHa strongly predicted positive pain relief after surgery, with a sensitivity of 90.5% and specificity of 100%. However, pain response to GnRHa poorly predicted intra-operative pathological findings such as endometriosis or adenomyosis. The study highlights the potential utility of pre-operative GnRHa in patient selection and counselling but notes limitations including small sample size, retrospective design, heterogeneous treatments, and qualitative pain assessments, recommending larger prospective studies for confirmation.