published results
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.
A painful lump on your scar? Have your MRI reviewed
Send your MRI (or ultrasound) and its report to the interventional radiology team at Cochin. We reply within 48 working hours. No referral letter is required; one is welcome if you have it.
✉ Contact form 📝 Contact form⚡ At a glance — key figures
Percutaneous cryoablation destroys abdominal wall endometriosis nodules — often on a caesarean scar — using cold (−40 °C) delivered through fine needles under CT or ultrasound guidance, without reopening the scar and without surgery.
| Criterion | Data |
|---|---|
| Effect on pain | Complete or near-complete relief in 80–93% of cases |
| Scar | No new scar — needle treatment, no surgical revision of the abdominal wall |
| Anaesthesia / stay | General anaesthesia in most cases (local possible for superficial nodules) — day case |
| Recovery | Return to activities within a few days (vs several weeks after surgery) |
| Recurrence / new nodule | Possible — cryoablation is repeatable, and surgery remains available |
| Cost | Covered by French national health insurance at Cochin AP-HP — no out-of-pocket fees |
Sources: published series on cryoablation of abdominal wall endometriosis, including our centre's experience as one of the pioneering centres. Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.
❄️ 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
Anaesthesia : Local anaesthesia with light sedation for superficial nodules; general anaesthesia for deeper or more complex nodules
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 extensively on this technique. 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)
🔬 What the studies say (systematic reviews)
According to PubMed, three recent systematic reviews have assessed percutaneous cryoablation for abdominal wall endometriosis. All rely on non-randomised studies:
- Bodard et al., Insights into Imaging 2024 (8 studies): median local pain from 8/10 to 1/10; complete local pain response 80 to 100% depending on the series; median pain-free survival 76.8% at the longest follow-up; major complications under 2%, minor complications 3.5 to 11%. PubMed · DOI
- Kaça do Carmo et al., Br J Radiol 2025 (meta-analysis, 4 studies, 126 patients): mean VAS reduction of 5.97 points, pooled satisfaction 93.1%, adverse events 5.5%. All included studies were retrospective. PubMed · DOI
- Razakamanantsoa et al., J Minim Invasive Gynecol 2024 (51 articles, 2,674 patients, surgery and percutaneous techniques): surgery gave the best local control (median 100%); cryoablation relieved pain in 79.2% with fewer minor adverse events (8.7% versus 17.5% after surgery). PubMed · DOI
The authors note that no randomised trial has yet compared cryoablation with surgery: the choice is made case by case with the patient, according to nodule size and location, symptoms and preferences.
Data from our team: in ongoing studies at Cochin (not yet published), efficacy reaches 99 to 100%. These preliminary results do not replace the published data above.
❓ FAQ
Is a painful lump on my caesarean scar, worse during periods, endometriosis?
This is the typical presentation of abdominal wall endometriosis: a palpable nodule on or near the scar whose pain increases during periods. Diagnosis relies on examination and imaging (ultrasound, MRI). Other causes are possible (hernia, suture granuloma, lipoma, haematoma), so your imaging should be reviewed before any treatment.
Can hormonal treatment be enough for abdominal wall endometriosis?
Hormonal treatments that suppress periods can relieve symptoms, but they are not always effective or well tolerated, and pain may return when they are stopped. Recognised options are hormonal therapy, surgical excision and, more recently, percutaneous cryoablation. The choice is discussed with your doctor.
Is cryoablation as effective as surgery for abdominal wall endometriosis?
No randomised trial has compared the two. In a 2024 systematic review of 51 studies, surgery showed the best local control, while cryoablation relieved pain in about 79% of cases with fewer minor adverse events, with no incision. Cryoablation can be repeated and does not rule out later surgery.
How do I book a cryoablation for endometriosis in Paris?
Use the contact form to send your MRI, its report and, if possible, your caesarean report (attachments accepted: PDF/JPG/PNG up to 10 MB). The interventional radiology team at Cochin Hospital AP-HP (Pr Anthony Dohan) replies within 48 working hours. No referral letter is required; one is welcome if you have it.
How do I make an appointment?
Send an email to Contact form 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
🇩🇪 🇳🇱 International patients — Deutsch / Nederlands
🇩🇪 Auf Deutsch
Die perkutane Kryoablation der parietalen Endometriose (Kryotherapie der Endometriose-Narbe) wird am Hôpital Cochin AP-HP in Paris angeboten — eine minimalinvasive Alternative zur Operation, ambulant durchgeführt, ohne größere Narbenbildung. Unser Zentrum zählt zu den führenden europäischen Referenzzentren für diese Technik. Kontakt für internationale Patientinnen: Contact us
🇳🇱 In het Nederlands
Percutane cryoablatie van pariëtale endometriose (cryotherapie van het endometriose-litteken) wordt aangeboden in het Hôpital Cochin AP-HP in Parijs — een minimaal invasief alternatief voor chirurgie, ambulant uitgevoerd, zonder grote littekens. Ons centrum is een van de toonaangevende Europese referentiecentra voor deze techniek. Contact voor internationale patiënten: Contact us
✓ Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.