results since 2014
pain relief
(French health insurance)
❓ What is abdominal wall endometriosis?
Abdominal wall endometriosis (AWE) is a specific form of endometriosis where endometrial cells implant in the abdominal wall : most commonly at a caesarean section scar (occurring in approximately 0.4% of caesarean sections). Unlike deep pelvic endometriosis, AWE is localised and accessible to percutaneous cryoablation.
Symptoms include a painful, palpable nodule on the abdominal wall, with pain that typically peaks during menstruation and subsides between periods. Pain can be severely debilitating, with VAS scores often reaching 8/10 or above.
⚠️ Important distinction: Abdominal wall endometriosis is not the same as deep pelvic endometriosis (ovarian endometrioma, rectovaginal endometriosis). Deep pelvic endometriosis requires gynaecological surgery. AWE can be treated by percutaneous cryoablation : our specialty.
❄️ What is percutaneous cryoablation?
Cryoablation uses extreme cold (−40°C / −40°F) delivered through ultra-fine needles to destroy endometriotic tissue. The procedure is performed under CT or ultrasound guidance, allowing the radiologist to visualise the "ice ball" in real time and precisely protect surrounding structures.
Pre-procedure consultation : MRI of the abdomen and pelvis required to confirm diagnosis and plan treatment
Local anaesthesia : No general anaesthesia. Light sedation available if needed
CT-guided needle placement : Cryoprobe placed within the nodule with millimetre precision
Freeze-thaw cycles : Two cycles of 8–10 minutes at −40°C, visible on CT as an ice ball
Same-day discharge : 2–4 hours monitoring, home the same day
📊 Cryoablation vs Surgery : Comparison
| Criterion | ❄️ Cryoablation (Cochin) | 🔪 Surgery |
|---|---|---|
| Anaesthesia | ✅ Local (± light sedation) | ❌ General |
| Scar | ✅ None (2mm needle) | ❌ Surgical scar |
| Hospital admission | ✅ Outpatient (day case) | ❌ 1–3 nights |
| Recovery time | ✅ 24–48 hours | ❌ 2–4 weeks |
| Recurrence rate | ✅ <10% | Up to 20% |
| Pain relief | ✅ 80–93% complete relief | ~85% (more invasive) |
| Repeatable if recurrence | ✅ Yes | Difficult (adhesions) |
| Real-time visualisation | ✅ Ice ball visible on CT | No |
📈 Published results
Our team has published on this technique since 2014. The 2024 systematic review (Bodard, Dohan et al., Insights into Imaging) confirms long-term efficacy:
📚 Key publications:
• Cornelis FH, Moyne T, Dohan A. Percutaneous image-guided cryoablation of abdominal wall endometriosis: towards a novel standard of care? Diagn Interv Imaging. 2024.
• Bodard S, Razakamanantsoa L, Geevarghese R, O'Gorman J, Dohan A et al. Insights Imaging. 2024.
🌍 For international patients
💰 Cost & insurance
At Cochin Hospital AP-HP, there are zero extra fees : the procedure is fully covered by the French Assurance Maladie. EU patients with a European Health Insurance Card (EHIC) are covered. Non-EU patients should contact us for a cost estimate.
🗣️ Language
Our team speaks English, French, German and Italian. Medical correspondence, reports and consultation can be conducted in English.
📋 What to bring
- Recent pelvic and abdominal wall MRI (within 6 months)
- Previous surgical reports
- List of current medications
📍 Location
Hôpital Cochin – Port-Royal AP-HP
27 rue du Faubourg Saint-Jacques
75014 Paris, France
🚇 Saint-Jacques (Metro line 6) · Port-Royal (RER B)
❓ FAQ
How do I make an appointment?
Send an email to ri.cch@aphp.fr with your MRI report and a brief description of your symptoms. We will reply within 48 hours. You can also use our online medical opinion form.
Can this treat my deep pelvic endometriosis?
No. Cryoablation treats abdominal wall endometriosis only. Deep pelvic endometriosis (ovarian cysts, rectovaginal lesions) requires gynaecological surgery. We work closely with the gynaecology department at Cochin for patients with both types.
Will cryoablation affect my fertility?
Cryoablation of the abdominal wall does not affect ovarian function or fertility. Pregnancies have been reported after the procedure. This question is discussed on an individual basis at the consultation.
What if the endometriosis recurs?
The recurrence rate is less than 10% at 5 years. If recurrence occurs, a second cryoablation session can be performed.
📄 Patient Information Sheet
✅ Covered by French Assurance Maladie · Zero extra fees · EU EHIC accepted · Private insurance accepted