FAQs on Superior Hypogastric Plexus Block in Atlanta

A superior hypogastric plexus block is used to control severe pelvic, abdominal, and/or perineal pain in patients who do not respond to oral medications, or those who have side effects to these medicines.

The superior hypogastric plexus is a nerve mass that involves nerves originating from the descending colon, perineum, vagina, uterus, urethra, bladder, rectum, testes, penis, and prostate. This collection of nerves is located behind the fifth lumbar intervertebral disc in the posterior peritoneal space. The block helps pain that arises from any of those regions.

What conditions are treated with the superior hypogastric plexus block?

The superior hypogastric plexus block is used to block pain associated with radiation injury, endometriosis, cancers, ovarian cysts, dysmenorrhea, myofascial pain syndrome, interstitial cystitis, pelvic fibrosis, adhesion pain, functional abdominal pain, and chronic pelvic pain.

Why is the superior hypogastric plexus block done?

This procedure is performed as a diagnostic or therapeutic block. For most patients, the doctors choose to use the superior hypogastric plexus block for diagnostic purposes. With a diagnostic block, the injection of a local anesthetic (bupivacaine or lidocaine) tests the patient’s response to the block. With a therapeutic block, patients with a documented positive response will be administered a neurolytic agent (phenol or alcohol), which destroys the nerve roots to provide long-term pain relief.

How is the superior hypogastric plexus block performed?

If the patient is able and his/her anatomy allows for it, the procedure is done with the posterior approach. With this approach, the patient lays on his/her stomach so the doctor can access the plexus through the lower back vertebrae (L5 and S1). The skin and deeper tissues are numbed with a local anesthetic.

The Atlanta pain management doctor then makes two injections using x-ray guidance to assure proper needle placement. To confirm correction placement, contrast dye is used. Once the needle is in place, the medications are injected. After injection, the needle is removed and a bandage is applied. The total time for the procedure is around 15 minutes.

What can I expect after the procedure?

You will probably experience soreness at the injection site right after the superior hypogastric plexus block. You will remain in the recovery room for 30-45 minutes, and a nurse will monitor your pain and vital signs. If a sedative is given, you will not be permitted to drive home, so be sure to bring someone with you.

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

As with any minimally invasive treatment, there are a few risks associated with this procedure. Rare complications include infection, blood vessel damage, bleeding, nerve damage, or paralysis. In addition, there is a chance of an allergic reaction to any of the medications or contrast dye used during the procedure.

What are the benefits of the superior hypogastric plexus block?

The superior hypogastric plexus block can provide temporary pain relief for many patients, but each person is different. This procedure is a low-risk, non-surgical treatment that brings long-lasting relief and reduces the need for oral medication use.

Is the superior hypogastric plexus block effective?

Many studies support the effectiveness of the superior hypogastric plexus block. In one clinical study, the block was found to be useful for patients with pelvic pain associated with cancer, with a 70% success rate reported. In a study of patients with chronic pelvic pain of varying causes, a 73% efficacy rate was noted.