Abstract Background: Abdominal wall endometriosis (AWE) is a rare form of endometriosis that often results in cyclic abdominal pain. The current treatment algorithm for AWE is not well established. Radiofrequency ablation (RFA) is an emerging technique that shows promise in treating AWE. Objective: This retrospective study aims to evaluate the safety and efficacy of ultrasound (US)-guided RFA for patients with AWE at the Security Forces Hospital in Riyadh, Saudi Arabia, between January 2020 and January 2024. Methods: Forty-two female patients with pathologically confirmed AWE who underwent US-guided RFA were included in the study. Lesions were assessed radiologically before the procedure using abdominal US, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All patients were followed for a minimum of 6 months after the intervention, with MRI used to evaluate lesion response. Treatment efficacy was assessed based on symptom relief, lesion volume reduction, and complication rates during the follow-up period. Results: Patient ages ranged from 28 to 52 years, with a median age of 42 years. All patients had a history of cesarean section and presented with cyclic pain. Preprocedure imaging revealed irregular hypoechoic lesions on US, solid soft-tissue masses on CT, and low signal intensity with heterogeneous enhancement on MRI. Histopathology confirmed the presence of endometrial cells in all cases, with most patients (40.48%) having lesions located below the scar. The majority of patients (95.2%) required only a single session of RFA. The complications included a minor scar wound, occurring in one case (2.4%). Complete radiological resolution was achieved in all patients (100%). Conclusion: This study demonstrates that RFA is a safe and effective treatment for AWE, offering significant symptom relief with minimal complications. Further research is warranted to validate these findings and optimize the treatment protocol.
Almawi et al. (Thu,) studied this question.