Resolution of Pain after Percutaneous Image-Guided Cryoablation of Extraperitoneal Endometriosis

J Vasc Interv Radiol. 2023 Jul;34(7):1192-1198. doi: 10.1016/j.jvir.2023.03.025. Epub 2023 Mar 30.

Abstract

Purpose: To retrospectively evaluate the relief of pain after percutaneous image-guided cryoablation of symptomatic extraperitoneal endometriosis (EE).

Material and methods: From 2017 to 2022, cryoablation of EE was performed at a single institution on a total of 47 lesions in 42 consecutive patients (median age, 37 years; interquartile range [IQR], 33-39.5 years). Patient and procedural characteristics were reviewed retrospectively. Tolerance and outcomes in terms of pain and patient satisfaction were evaluated.

Results: The median follow-up duration was 13.5 months (IQR, 1.1-37.7 months) after cryoablation. The median pain-free survival rate was 93.8% (95% confidence interval [CI], 77.3-98.4) at 6 months and 82.7% (95% CI, 58.8-93.5) after 12 months. Pain decreased from a median of 8/10 (IQR, 7-9) on the visual analog scale to 0/10 (IQR, 0-1) at the last follow-up (P < .0001). The median Patient Global Impression of Change score recorded at the last follow-up was 1/7 (IQR, 1-2). The efficacy rate of cryoablation to avoid secondary surgery was 92.8% (39/42) per patient and 93.6% (44/47) per nodule treated. Four patients (9.5%, 4/42) experienced an adverse event in the days following the procedure, and 1 patient (2%) experienced a severe adverse event.

Conclusions: Percutaneous cryoablation is safe and effective in significantly reducing pain and obtaining local control of EE.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cryosurgery* / adverse effects
  • Cryosurgery* / methods
  • Endometriosis* / diagnostic imaging
  • Endometriosis* / etiology
  • Endometriosis* / surgery
  • Female
  • Humans
  • Pain / etiology
  • Retrospective Studies
  • Treatment Outcome