1 Ali Mahdavi

1Shahid Beheshti University of Medical Sciences

Background:

Abdominal wall endometriosis (AWE) is a rare condition that usually develops in a surgical scar resulting from a Caesarean section. Its treatment options consist of the excision of the lesion and/or hormonal therapies, although wide surgical excision is the treatment of choice in the literature. Here we review a case series of abdominal wall endometriosis treated with radio-frequency ablation (RFA) under ultrasound guidance.

Material(s) and Method(s):

8 patients included in this study all of them presenting with palpable mass (es) in abdominal wall close to cesarean scar. The patients underwent full diagnostic work up including ultrasound and MRI. Written informed consents were obtained. Before RFA, the patient’s pain level was assessed using a validated visual analogue scale (VAS) for pain assessment. RFA was performed under general anesthesia with Neuro N50 generator with 500KHZ up to 99c temperature for maximum 10 minutes. The patient’s pain level was assessed one week, one month and 4 months after the procedure.

Result(s):

Before the procedure mean VAS was 8.2 and one week after the procedure reduced to 2.3, one month to 1,5 and 4 months to 1.2. Four patients reported no pain after one month (VAS=0). No major complications was observed except for moderate erythema at RFA site resolving after one week.

Conclusion(s):

Medical management of AWE often results in temporary relief. Wide surgical excision may create a defect in the abdominal wall and may increase the risk of hernia formation. RFA is used in many solid and superficial organs such as thyroid however there are no studies in the literature on the role of RFA in the treatment of pain related to endometriosis. Here we suggest that RFA could be considered as an alternative treatment for AWE.