Percutaneous hydrotomy involves injecting small volumes of saline solution, sometimes enriched with minerals or trace elements, under the skin in contact with painful areas. This loco-regional technique aims to rehydrate tissues, stimulate microcirculation, and reduce tensions that cause chronic pain. Finding a practitioner trained in this approach in France requires a specific process, as the practice is subject to disciplinary decisions that complicate access to usual directories.
Suspension by professional orders: what hinders the search for a practitioner
The National Council of the Order of Physicians has classified percutaneous hydrotomy as a new unproven technique in a decision dated June 27, 2023. The National Council of the Order of Nurses took a similar position in May 2023. These decisions have led to disciplinary sanctions against several healthcare professionals who practiced the technique.
The direct consequence for patients is concrete: the International Association of Percutaneous Hydrotomy (AIHP) has removed from its website the list of practitioners operating in France. Dr. Bernard Guez, founder of the association, stated that this measure aimed to protect the practice of healthcare professionals still active.
A recent development deserves to be noted. The Council of State annulled, on October 10, 2024, the decision of the national disciplinary chamber of the order of nurses that prohibited the practice. The Council of State found that the injunction issued was not related to any of the powers held by disciplinary chambers. This annulment does not lift all restrictions, but it modifies the legal framework for nurses trained in the technique.
To locate a practitioner despite this context, consulting a list of percutaneous hydrotomy practitioners in France provides updated geographical references, where institutional sites do not list this specialty.
Verify a percutaneous hydrotomy practitioner via official directories
Specialized directories like Resalib sometimes list practitioners trained in percutaneous hydrotomy. The problem is that these private platforms do not guarantee either the actual training of the professional or the currency of their practice.
The Health Directory of the Digital Health Agency (ANS) is a more reliable tool for an initial verification. It provides access to the administrative data of healthcare professionals from the RPPS directory (Shared Directory of Healthcare Professionals). This register confirms the practitioner’s identity, declared specialty, and place of practice.
The ANS directory does not mention percutaneous hydrotomy as a specific skill. Its utility is indirect: to verify that a doctor or nurse found through another channel is indeed registered with the order, in practice, and located at the indicated address. Cross-referencing a niche directory with an institutional database reduces the risk of consulting an unqualified practitioner.
Geographical availability of practitioners in France
The distribution of practitioners trained in percutaneous hydrotomy is very uneven across the territory. Search results show concentrations in certain urban areas, while entire regions seem devoid of referenced professionals.
This inequality is due to several factors:
- The training in the technique was provided by a limited number of organizations, which mechanically limits the pool of practitioners.
- The disciplinary decisions of 2023 have led some professionals to stop communicating about this practice, even if they continue to perform it.
- Institutional directories (Health Directory, FHF) do not categorize this technique, making it invisible in specialty searches.
In practice, the search involves identifying city by city, followed by direct contact with the office to confirm that the practitioner still offers sessions. A phone call remains the most reliable way to obtain an updated response.
Criteria for choosing a practitioner trained in this therapeutic technique
The practitioner’s training is the first point to verify. Percutaneous hydrotomy is not taught in the standard medical curriculum. Professionals who practice it have generally undergone additional training, often organized by the AIHP or affiliated structures. Asking the practitioner to specify their training remains the most direct approach.
The medical profile of the professional also matters. The technique is practiced by general practitioners, sports doctors, mesotherapists, and nurses. A practitioner familiar with mesotherapy already masters the skills of subcutaneous injection, which constitutes a relevant technical foundation.
Before making an appointment, several elements deserve clarification:
- The type of solution injected (saline solution only, Quinton water, addition of vitamins or trace elements) and the justification for the choice.
- The number of sessions generally required for the type of pain concerned, and the spacing between each session.
- The fee per session and the level of coverage, knowing that percutaneous hydrotomy is not reimbursed by Health Insurance.
- The existence of a preliminary consultation with a referring doctor, often recommended to establish a diagnosis before starting the protocol.
Percutaneous hydrotomy and mesotherapy: a distinction to know
Differences in protocol
Mesotherapy injects small doses of medication into the dermis or hypodermis. Percutaneous hydrotomy is distinguished by the use of non-medicated solutions, primarily saline solution or isotonic seawater. The postulate is different: mesotherapy targets a local pharmacological effect, while hydrotomy aims for a mechanical and cellular effect of tissue rehydration.
Consequence for the search for a practitioner
This technical proximity explains why some mesotherapists also offer percutaneous hydrotomy. Searching for a mesotherapist trained in hydrotomy in a directory like that of the ANS may yield results that a search for “percutaneous hydrotomy” alone would not reveal.
The regulatory context surrounding percutaneous hydrotomy has been evolving since the partial annulment pronounced by the Council of State in October 2024. This decision could gradually facilitate the visibility of trained practitioners. In the meantime, the combination of specialized directories, verification via the RPPS directory, and direct contact with the office remains the most reliable method to find a competent professional near you.