Abstract:Objective To investigate the clinical efficacy of combined gonadotropin-releasing hormone agonist(GnRH-a) therapy in patients with ovarian endometrioma after conservative surgery. Methods Using a retrospective cohort study analysis, 206 patients who underwent conservative surgery for ovarian endometriosis cysts at the Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine from December 2014 to December 2018 were selected and divided into 138 cases in the observation group(postoperative combined GnRH-a use for 6 months) and 68 cases in the control group(postoperative with no drug). Recurrence between two groups and the scores of dysmenorrhea, pain during in tercouse（PDI）, and chronic pelvic pain were compared between two groups at different times in 2 years after surgery. Results In the 2 years follow-up, the observation group was superior with statistical significance in the comparison of chronic pelvic pain and dysmenorrhea scores between the two groups and time points(P＜0.05). There was no significant difference in intergroup effect and time effect of sexual intercourse pain (P>0.05). The recurrence rate of patients in the observation group was lower than that of the control group in the first year after surgery(3.62% vs 11.77%, P＜0.05), while no significant difference in recurrence rate of two groups was found in the second year after surgery (P>0.05), but the 2-year cumulative recurrence rate in the observation group was lower than that in the control group (13.24% vs 25.00%, P<0.05). Conclusion GnRH-a can be a choice for postoperative pain management and recurrence prevention in endometriosis.