FAQs on Superior Hypogastric Plexus Block in Nashville TN

The superior hypogastric plexus block is used to alleviate pelvic pain. The superior hypogastric plexus is a bundle of nerves that supply the colon, rectum, penis, testes, prostate, vulva, vagina, perineum, uterus, bladder, and urethra. These nerves lie in front of the vertebral column of the lower spine. This block helps people who experience pain in any of these regions.

What conditions are treated with the superior hypogastric block?

Any painful condition of the pelvic region can be treated with the superior hypogastric block. These conditions include:

  • Endometriosis
  • Any cancer of the pelvic region
  • Radiation injury
  • Chronic pelvic pain
  • Ovarian cysts
  • Myofascial pain syndrome
  • Pelvic fibrosis
  • Functional abdominal pain

Why is the superior hypogastric plexus block done?

The superior hypogastric plexus block can be both diagnostic and therapeutic. With the diagnostic block, an injection of lidocaine or bupivacaine (anesthetic) is used to test the patient’s response to the block. For patients who have a documented positive response, the doctor administers a neurolytic agent (absolute alcohol or phenol), which destroys a portion of the nerve to offer long-term pain relief.

What can I expect before the procedure?

Before the superior hypogastric block, you should discuss any and all medications with the doctor. Blood-thinning agents must be held 5-7 days prior to the procedure. In addition, you should bring someone to drive you home, as driving is not permitted for 24 hours. When you arrive at the medical facility, a nurse will go over the risks and benefits of the procedure and have you sign a consent form. In addition, an IV catheter will be positioned in your arm to administer necessary medications.

How is the superior hypogastric block performed?

The superior hypogastric block procedure takes around 15 minutes, and you will be monitored during the entire process. The doctor will have you lie face down on your stomach and cleanse the lower back with an antiseptic solution. The skin is numbed with a local anesthetic, and the needles are positioned using fluoroscopic guidance to ensure proper placement. Contrast dye is injected to assure the needles are in correct position. After the medication is injected, the needle is removed and a bandage is applied.

What happens after the procedure?

After the superior hypogastric block, you will be moved to the recovery room, where a nurse will monitor your vital signs and pain for 30-45 minutes. Expect to experience some mild tenderness at the injection site, but this gradually goes away.

What risks and complications are associated with the superior hypogastric plexus block?

As with any minimally invasive treatment, a few complications are associated with this procedure. These include bleeding, infection, blood vessel damage, nerve damage, and paralysis. Additionally, there is a slight chance of allergic reaction to the contrast dye and medications used during the procedure.

What is the success rate of the superior hypogastric plexus block?

The superior hypogastric plexus block is a low-risk procedure that provides temporary relief of pain. However, it does not work for all patients. In a clinical study of patients with pelvic pain associated with cancer, this procedure had a 70% success rate. Another study of chronic pelvic pain, the efficacy rate was noted at 73%.

Resources

Medscape (2011). Superior hypogastric plexus block. Retrieved from: http://www.medscape.com/viewarticle/408975_4

Schultz D (2007). Inferior hypogastric plexus blockade: A transsacral approach. Pain Physician, 10:757–63.