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Cochin Hospital – Port-Royal · AP-HP · Paris Cité University · Paris, France
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Interventional Radiology Cochin Paris

Cryoablation : Abdominal Wall Endometriosis

Interventional Radiology · Cochin Hospital AP-HP · Paris, France

❄️ Our flagship expertise · Major reference centre

Cryoablation for Abdominal Wall Endometriosis

Outpatient · No surgery · No scar · 80–93% pain relief
Reference
major centre with
published results
80–93%
complete
pain relief
0 €
extra fees
(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.

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.

CriterionData
Effect on painComplete or near-complete relief in 80–93% of cases
ScarNo new scar — needle treatment, no surgical revision of the abdominal wall
Anaesthesia / stayGeneral anaesthesia in most cases (local possible for superficial nodules) — day case
RecoveryReturn to activities within a few days (vs several weeks after surgery)
Recurrence / new nodulePossible — cryoablation is repeatable, and surgery remains available
CostCovered 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.

1

Pre-procedure consultation : MRI of the abdomen and pelvis required to confirm diagnosis and plan treatment

2

Anaesthesia : Local anaesthesia with light sedation for superficial nodules; general anaesthesia for deeper or more complex nodules

3

CT-guided needle placement : Cryoprobe placed within the nodule with millimetre precision

4

Freeze-thaw cycles : Two cycles of 8–10 minutes at −40°C, visible on CT as an ice ball

5

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✅ YesDifficult (adhesions)
Real-time visualisation✅ Ice ball visible on CTNo

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:

Complete or near-complete pain relief80–93%
Pain-free survival at 12 months89.2%
Pain-free survival at 5 years76.8%
Major complications<2%

📚 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

📄

Patient information sheet

Download before your consultation.

📥 Download (PDF)

✅ 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: ri.cch@aphp.fr

🇳🇱 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: ri.cch@aphp.fr

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.

🏥 Le service 📰 Actualités 🔬 Recherche & essais cliniques

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