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Cryoablation is a minimally invasive solution to treat endometriosis

Abdominal Wall Endometriosis

Cryoablation: Minimally invasive treatment option

Understanding Endometriosis

Endometriosis is a condition that can affect women from their very first period and continue through menopause, no matter their background. It happens when tissue similar to the lining of the uterus grows outside of it, which can cause pain and other symptoms. The location of the pain is mostly in the lower abdomen, lumbosacral region and central pelvis. Doctors are still learning about why this occurs, and there is no single known cause. However, new research suggests that changes in how the immune system works may play a role. 

8 - 15% 

of women approximately are affected by Endometriosis1

6.6 million

women worldwide may experience abdominal wall endometriosis, a type of endometriosis that occurs outside the pelvic area.2,4

What is Abdominal Wall Endometriosis?

Although endometriosis most commonly affects pelvic organs, it can occasionally occur outside the pelvis. Outside of the pelvis, Abdominal Wall Endometriosis is the most common type of Endometriosis. Abdominal wall endometriosis refers to the infiltration of endometrial glands and mesenchyme into the abdominal wall, mostly secondary to a history of gynecological surgery such as caesarean section also referred to as  C-section, uterine, and ovarian surgery.4

The most common symptoms of endometriosis closely associated with menstrual cycle, and  include:

  • Pain immediately before and during menstruation
  • Pain during sexual intercourse
  • Heavy and irregular menstrual bleeding (3)
  • increased menstrual flow and prolonged periods.
  • Reduced fertility

Those affected often experience significant stress in their everyday lives, which can considerably reduce their quality of life.

A gynecologist usually diagnoses AWE using imaging techniques such as ultrasound, CT scan, or MRI. The choice of test depends on your symptoms and what will give the clearest picture.  

There are several ways to manage and treat Abdominal Wall Endometriosis. Treatments can range from medication to relieve pain, to minimally invasive procedures like cryoablation, and even surgery for more severe cases.

  • Surgery treatment is a removal of the affected tissue through an operation.
  • Cryoablation, a minimally invasive treatment freezing the affected tissue to relieve pain.
  • High-Intensity Focused Ultrasound (HIFU), a technique using focused ultrasound waves to treat the tissue without surgery.
  • Hormonal Therapy, medicines that control hormones to ease symptoms.
  • Acupuncture or Sclerotherapy, an alternative treatments that may help in some cases.

If you suffer from  Abdominal Wall Endometriosis, you might be cared for by different specialists depending on your needs. These can include a gynecologist, an endocrinologist, a general surgeon, an imaging specialist, or sometimes an oncologist.

Your doctor will work with you to choose the option that best fits your symptoms, lifestyle, and overall health.

What is cryoablation treatment and how does it work?

Cryoablation is a minimally invasive procedure that destroys abnormal cells using extreme cold delivered through a thin probe inserted into the tumor under imaging guidance. The therapy is usually performed at the hospital’s interventional radiology department and involves several steps:

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Your doctor places the Treatment Needle Safely
First, imaging technologies (computed tomography and/ or ultrasound) are used to insert at least one thin needle into the lesion. 

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 An Ice Ball is created and the lesion Frozen
The noble gas argon is then passed through the needle(s). Extreme cold creates an “ice ball” that encompasses the lesion and a margin of surrounding tissue. The abnormal cells are destroyed through controlled freezing.

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Your doctor will move through a gentle thawing and re‑freezing
After freezing, the tissue is thawed again and possibly frozen a second time, resulting in extensive destruction of the abnormal cells. 

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Post-Procedure Care
After the procedure, your doctor will remove the needle(s) and will cover the puncture site with a bandage. 

Your Abdominal wall Endometriosis Care: what you might expect before, during and after a cryoablation treatment

Cryoablation is often performed as a same-day outpatient procedure, meaning many patients go home the same day. Cryoablation can be performed under local anesthesia, conscious sedation, or general anesthesia. The type of anesthesia depends on the size and location of the lesion, the complexity of the procedure, and your overall health. Your doctor will discuss the most appropriate option with you.  Because cryoablation is minimally invasive, it offers several benefits for patients:

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Cryoablation is a minimally invasive procedure to treat abdominal wall endometriosis nodules

Effectively reduces symptoms. It is a minimally invasive treatment option, so recovery is easier. (5,6,7)

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Cryoablation helps reduce pain

Cryoablation is an effective pain relief for Abdominal wall endometriosis, with about 8 out of 10 women feeling significant pain relief after the procedure. (5,6)

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Cryoablation procedure is safe and gentle

Cryoablation treatment has very few risks and doesn’t leave visible scars, making it a good option for any women concerned about appearance. (5,6)

Transition

Cryoablation is a repeatable treatment

If needed, cryoablation can be repeated without significantly increasing risk6,8, in case the pain returns.

See how cryoablation made a difference for patients with endometriosis

Eugénia’s Story

This material describes real personal experiences. Individual results may vary. Patients can experience varying levels of complications or hospital stay.
Consult with your physician to determine if you are a candidate for this procedure and what you may gain from the therapy.

Is cryoablation right for me?

Cryoablation is only suitable for treating abdominal wall endometriosis, a specific variant that affects 1.3% of endometriosis patients who undergo surgery. It is not currently used for other forms of the disease. It may be considered for patients who are unable to undergo another surgery or who prefer a non‑surgical treatment option. Discuss with your doctor whether cryoablation is an option for you. Hospitals with experience in cryoablation can carefully assess whether this therapy is suitable for you.

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Are there any risks associated with cryoablation treatment?

Your doctor will inform you that every medical procedure involves risks. Before undergoing cryoablation therapy, discuss all potential risks, benefits, indications, contraindications, and alternatives with your doctor who will define whether this treatment is appropriate based on your individual health situation. 

DISCLAIMER

This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

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The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France.

References

1. Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, et al. World Endometriosis Society consensus on the classification of endometriosis. HumReprod2017;32:315–24.

2.  Xu, Shuangfei MSca,#; Zhang, Yi MDa,#; Ye, Peng PhDb,#; Huang, Qin PhDc,#; Wang, Yinan MSca; Zhang, Yan PhDd,*; Yang, Chaogang PhDe,*; Ding, Jinli MDa,*. Global, regional, and national burden of endometriosis among women of childbearing age from 1990 to 2021: a cross-sectional analysis from the 2021 global burden of disease study. International Journal of Surgery 111(9):p 5927-5940, September 2025. | DOI: 10.1097/JS9.0000000000002647

3. Bulun SE, Yilmaz BD, Sison C, et al. Endometr Endocr Rev. 2019;40(4):1048–79. h t t p s : / / d o i . o r g / 1 0 . 1 2 1 0 / e r . 2 0 1 8 - 0 0 2 4 2.

4. Carsote M, Terzea DC, Valea A, Gheorghisan-Galateanu AA. Abdominal wall endometriosis (a narrative review). Int J Med Sci. 2020;17(4):536–42. h t t p s : / / d o i . o r g / 1 0 . 7 1 5 0 / i j m s . 3 8 6 7 9. Published 2020 Feb 10.

5.Bachour R, Sengmanivong N, Vidal F, Goumarre C, Lapègue F, Destombes L, Gandois HC, Gac YTL, Chantalat E, Capdet J, Blais D, Guenego A, Sans N, Bilfeld MF. Percutaneous cryoablation of abdominal wall endometriosis: An analysis of 38 patients. Diagn Interv Imaging. 2024 Sep;105(9):319-325. doi: 10.1016/j.diii.2024.02.010. Epub 2024 Mar 11. PMID: 38467523.=6

6.Najdawi M, Razakamanantsoa L, Mousseaux C, Bendifallah S, Touboul C, Thomassin‑Naggara I, et al. Resolution of pain after percutaneous image‑guided cryoablation of extraperitoneal endometriosis. J Vasc Interv Radiol. 2023;34(7):1192‑1198. doi:10.1016/j.jvir.2023.03.025.=1

7.Maillot J, Brun JL, Dubuisson V, Bazot M, Grenier N, Cornelis FH. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. 2017 Oct;27(10):4298-4306. doi: 10.1007/s00330-017-4827-7. Epub 2017 Apr 10. PMID: 28396995.=1

8.Marcelin, C., Maas, P., Jambon, E. et al. Long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis. Eur Radiol 34, 6407–6415 (2024). https://doi.org/10.1007/s00330-024-10689-5=5