{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:38:05Z","timestamp":1778528285283,"version":"3.51.4"},"reference-count":20,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Abdominal wall endometriosis (AWE) is a rare but debilitating condition, often occurring in surgical scars after Caesarean sections. It is characterized by cyclic pain and a palpable mass, significantly impacting patients\u2019 quality of life. Traditional treatments, including hormonal therapy and surgery, have limitations, prompting interest in minimally invasive techniques such as cryoablation. This study evaluates the efficacy and safety of percutaneous image-guided single-probe cryoablation using liquid nitrogen for symptomatic AWE. Purpose: To evaluate the effectiveness and safety of percutaneous image-guided single-probe cryoablation using liquid nitrogen in treating symptomatic AWE lesions, with a primary objective to assess pain relief using the Visual Analog Scale (VAS). Materials and Methods: This retrospective, single-center study included 14 patients (23 lesions) treated with percutaneous cryoablation between September 2022 and April 2025. Clinical, imaging (MRI and ultrasound), and procedural data were analyzed. Pain scores (VAS scale) were assessed before treatment and at 3-month follow-up. Hydro- and\/or carbo-dissection were used to protect adjacent structures. Response to treatment was evaluated with MRI and clinical follow-up. Statistical analysis was performed using median, range, and percentage calculations, with comparisons made using the Mann\u2013Whitney test. Results: A total of 23 AWE lesions were treated in 14 patients (mean age: 39.6 years). The median lesion volume was 3546 mm3, with a range from 331 mm3 (8 \u00d7 4.6 \u00d7 9 mm) to 45,448 mm3 (46 \u00d7 26 \u00d7 38 mm). Most of the lesions were located in the muscle (69.6%, n = 16), while 17.4% (n = 4) involved both muscle and subcutaneous tissue, and 13.0% (n = 3) were purely subcutaneous. Among the 23 treated lesions, 8.7% (n = 2) appeared as purely hemorrhagic, 13.0% (n = 3) as fibrotic, and 78.3% (n = 18) were classified as mixed, based on imaging characteristics. Procedures were performed under general anesthesia in 65% of cases and under sedation in 35%. Hydrodissection was used in 48% of lesions, carbo-dissection in 4%, and combined hydro\u2013carbo-dissection in 26%. A single 13G cryoprobe was used in 83% of cases, and a 10G probe in 17%. The median ablation time was 15 min (range: 6\u201328 min), and the median total procedure time was 93 min (range: 22\u2013240 min). Pain scores significantly decreased from a median of 8\/10 (range: 6\u201310) before treatment to 0\/10 (range: 0\u20132) at follow-up (p &lt; 0.0001). MRI follow-up confirmed complete coverage of the ablation zone and disappearance of hemorrhagic inclusions in all cases. Two patients (14%) required re-treatment, both with satisfactory outcomes. No peri- or post-procedural complications were observed, and no visible scars were noted. Conclusions: Percutaneous cryoablation using a single probe with liquid nitrogen is a safe and effective treatment for AWE, offering significant pain relief, minimal morbidity, and excellent cosmetic outcomes. It should be considered as part of multidisciplinary care. Further prospective studies with longer follow-up are warranted to confirm these findings.<\/jats:p>","DOI":"10.3390\/jpm15080373","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:30:38Z","timestamp":1755091838000},"page":"373","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Personalized Percutaneous Single-Probe Cryoablation Using Liquid Nitrogen in the Treatment of Abdominal Wall Endometriosis"],"prefix":"10.3390","volume":"15","author":[{"given":"Ghizlane","family":"Touimi Benjelloun","sequence":"first","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malek","family":"Mokbli","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek","family":"Kammoun","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinda","family":"Ghabri","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Skander","family":"Sammoud","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wissem","family":"Nabi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Letouzey","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Paul","family":"Beregi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7816-8178","authenticated-orcid":false,"given":"Julien","family":"Frandon","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, N\u00eemes University Hospital Center, University of Montpellier-N\u00eemes, 30900 N\u00eemes, France"},{"name":"Medical Imaging Group N\u00eemes (MIG N\u00eemes), 30900 N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"M\u00e1rki, G., V\u00e1s\u00e1rhelyi, D., Rig\u00f3, A., Kal\u00f3, Z., \u00c1cs, N., and Bokor, A. (2022). Challenges of and possible solutions for living with endometriosis: A qualitative study. BMC Womens Health, 22.","DOI":"10.1186\/s12905-022-01603-6"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"616","DOI":"10.2214\/AJR.04.1619","article-title":"Abdominal Wall Endometriosis: Clinical Presentation and Imaging Features with Emphasis on Sonography","volume":"186","author":"Hensen","year":"2006","journal-title":"Am. J. Roentgenol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s13244-023-01485-8","article-title":"Pictorial essay: MRI evaluation of endometriosis-associated neoplasms","volume":"14","author":"Radzynski","year":"2023","journal-title":"Insights Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hu, S., Liu, Y., Chen, R., and Xiao, Z. (2022). Exploring the Diagnostic Performance of Magnetic Resonance Imaging in Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Abdominal Wall Endometriosis. Front. Physiol., 13, Available online: https:\/\/www.frontiersin.org\/journals\/physiology\/articles\/10.3389\/fphys.2022.819259\/full.","DOI":"10.3389\/fphys.2022.819259"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s00330-009-1658-1","article-title":"Appearance of abdominal wall endometriosis on MR imaging","volume":"20","author":"Busard","year":"2010","journal-title":"Eur. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1007\/s00261-019-02379-4","article-title":"Percutaneous cryoablation of abdominal wall endometriosis: The Mayo Clinic approach","volume":"45","author":"Welch","year":"2020","journal-title":"Abdom. Radiol."},{"key":"ref_7","first-page":"13","article-title":"Abdominal wall endometriosis: Pathogenesis, diagnosis, and update on minimally invasive treatment options: A narrative review","volume":"10","author":"Zaucha","year":"2023","journal-title":"Ann. Laparosc. Endosc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.ogc.2022.02.013","article-title":"Abdominal Wall Endometriosis","volume":"49","author":"Foley","year":"2022","journal-title":"Obstet. Gynecol. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"W146","DOI":"10.2214\/AJR.10.7238","article-title":"Subcutaneous Abdominal Wall Masses: Radiological Reasoning","volume":"198","author":"Stein","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Clark, T., and Sabharwal, T. (2013). Overview of Thermal Ablation Devices: Cryoablation. Interventional Radiology Techniques in Ablation, Springer.","DOI":"10.1007\/978-0-85729-094-6"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"690","DOI":"10.2214\/AJR.16.17269","article-title":"Cryoablation of Abdominal Wall Endometriosis: A Minimally Invasive Treatment","volume":"209","author":"Dibble","year":"2017","journal-title":"Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4298","DOI":"10.1007\/s00330-017-4827-7","article-title":"Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: Comparison with surgery alone in a single institution","volume":"27","author":"Maillot","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.amjsurg.2020.07.028","article-title":"Cryoablation: A promising non-operative therapy for low-risk breast cancer","volume":"221","author":"Habrawi","year":"2021","journal-title":"Am. J. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S187","DOI":"10.1016\/j.jvir.2009.12.403","article-title":"Cryoablation: Mechanism of Action and Devices","volume":"21","author":"Erinjeri","year":"2010","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13244-023-01580-w","article-title":"Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system","volume":"15","author":"Narvaez","year":"2024","journal-title":"Insights Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1093\/bjr\/tqae171","article-title":"Liquid nitrogen-based cryoablation: Complication rates for lung, bone, and soft tissue tumors cryoablation","volume":"97","author":"Orsi","year":"2024","journal-title":"Br. J. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1002\/ijgo.14167","article-title":"Abdominal wall endometriosis: Report of 83 cases","volume":"159","author":"Benedetto","year":"2022","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.jvir.2023.03.025","article-title":"Resolution of Pain after Percutaneous Image-Guided Cryoablation of Extraperitoneal Endometriosis","volume":"34","author":"Najdawi","year":"2023","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.amsu.2021.01.029","article-title":"Clinico-pathological assessment of surgically removed abdominal wall endometriomas following cesarean section","volume":"62","author":"Hasan","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.amjsurg.2007.07.035","article-title":"Abdominal wall endometriosis: A surgeon\u2019s perspective and review of 445 cases","volume":"196","author":"Horton","year":"2008","journal-title":"Am. J. 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