Feasibility, safety, and short-term efficacy of ultrasound-guided radiofrequency ablation for abdominal wall endometriosis: preliminary results from a single center

Nhan Hien Phan, Le NT, Ngoc Trung Le, Nguyen TK, Thanh Khiem Nguyen, Thai Binh Nguyen, Nguyen TB
Abdominal radiology (New York) · 2026 · doi:10.1007/s00261-026-05766-w · PMID:42667387 · W7204649298
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This single-center study evaluated ultrasound-guided radiofrequency ablation for abdominal wall endometriosis in nineteen patients, demonstrating the procedure's feasibility and safety with significant short-term reductions in pain severity and lesion size at three months.

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Abstract

PURPOSE: To evaluate the feasibility, safety, and short-term outcomes of ultrasound-guided radiofrequency ablation (RFA) for abdominal wall endometriosis (AWE). MATERIALS AND METHODS: This retrospective single-center study included 19 patients with AWE (mean age, 35.5 ± 5.0 years) with 29 lesions who underwent ultrasound-guided RFA between December 2023 and January 2026. AWE was diagnosed based on clinical symptoms and imaging findings on ultrasonography and magnetic resonance imaging; biopsy was performed in atypical cases. RFA was performed using an 18-gauge electrode with the moving-shot technique under local anesthesia combined with intravenous analgesia. Complications were classified according to the SIR classification. Short-term technical efficacy was assessed at 3 months based on clinical symptoms and changes in lesion size on imaging. RESULTS: All patients presented with abdominal pain, including 14 patients (73.7%) with cyclic pain. The mean preprocedural VAS score was 7.37 ± 1.42. A palpable mass was present in 17 patients (89.5%), and two patients (10.5%) had a history of prior surgery for AWE. The mean maximum lesion diameter decreased from 25.1 ± 17.47 mm before treatment to 13.4 ± 10.6 mm at 3 months (p < 0.01). The mean lesion volume decreased from 5.65 ± 7.41 mL to 1.27 ± 1.37 mL (p < 0.01). The mean VAS score decreased to 1.72 ± 2.78 at 3 months (p < 0.01). Three mild adverse events (15.8%) were observed. CONCLUSION: Ultrasound-guided RFA is a feasible and safe treatment option for AWE, providing short-term reductions in pain severity and lesion size.

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