Minimally Invasive Outpatient Procedure Effectively Treats Endometriosis

For more than a decade, Jennifer D., 46, experienced debilitating abdominal pain every time she sneezed.

She suffered from endometriosis, an often painful condition—impacting an estimated one in 10 women—in which tissue that normally lines the uterus grows outside the uterus and on organs in the abdomen or pelvis. Despite its prevalence, there are few effective treatment options.

In Jennifer’s case, she met with multiple doctors, tried different birth control pills, and even underwent a hysterectomy, yet the symptoms persisted and continued to affect her quality of life. “I couldn’t stretch, exercise, carry groceries, or sleep on my stomach for years,” she shared. “You experience such pain and don’t wish it for anyone.”

As the next step in her care, Jennifer met with Elisa Jorgensen, MD, an OB/GYN physician and expert in endometriosis treatment at Beth Israel Deaconess Medical Center (BIDMC)’s Endometriosis & Complex Pelvic Pain Center. As part of the work-up of her ongoing pain, and using advanced imaging techniques—including magnetic resonance imaging (MRI) and CT studies that are designed to look for endometrial deposits—she was found to have an endometrial tissue implant in a prior surgical scar. Occurring in one percent of women with endometriosis, this uncommon presentation can result in debilitating pain for patients.

A Minimally Invasive Advancement

Among Jennifer’s appointments was one with Muneeb Ahmed, MD, Chief, Interventional Radiology, BIDMC, who talked with her about a minimally invasive option called cryoablation.

Simply put, cryoablation is the controlled freezing of tissue that is induced around the tip of a thin needle that is placed in the target using real-time image guidance with a CT scan or ultrasound machine. While this technique is usually used to destroy cancerous cells, it is also effective at treating non-cancerous focal causes of pain, including abdominal wall endometriomas.

“Dr. Ahmed really took the time for me to understand the procedure,” said Jennifer, who underwent the treatment in March 2021. “The whole process, from arriving at the hospital to leaving, was amazing, and the team was so nice, too.”

Symptomatic abdominal wall endometrial implants can be especially difficult to treat when they don’t respond to medical therapy alone. Surgical removal of the endometrioma is the first treatment often considered but can be extensive and associated with a longer recovery period. Image-guided cryoablation can be performed as an outpatient procedure with one or two needle punctures and no stitches. Patients can expect a quick recovery and return to normal activities with generally great early response to symptoms.

Supporting Women’s Health

Cryoablation is just one offering in a suite of minimally invasive treatments designed to support women’s health at BIDMC. Other commonly treated conditions include uterine fibroids, uterine adenomyosis, and pelvic venous insufficiency.

The medical center has demonstrated a strong commitment to offering the best possible care for female patients with chronic pelvic pain. The Endometriosis & Complex Pelvic Pain Center at BIDMC comprises many different clinical subspecialties and complementary expertise to provide the most comprehensive care to patients suffering from chronic pelvic pain.

Soon after her outpatient appointment, Jennifer was completely pain-free.

“Chronic pain can be debilitating, often negatively impacting the lives of not just the patients, but their family members and those around them,” Ahmed explained. “I am very happy that cryoablation worked well to resolve Jennifer’s chronic endometrioma-induced pain, and that it has let her return to doing the things that she enjoys.”

“I can now pick up my 18-month-old grandson for the first time,” said Jennifer, who became emotional when she first realized her quality of life had finally been restored. “I 100 percent recommend this option for any female dealing with endometriosis.”

BIDMC's Interventional Radiology team is currently seeing new patients. To schedule a consultation, email BIDMC Interventional Radiology or call 617-754-2523.