FAQs on Superior Hypogastric Plexus Block Pain Relief

pelvic painjpgSuperior hypogastric plexus block injections are prescribed to treat all types of pelvic pain. The procedure is beneficial for those suffering from incessant, uncontrolled painful sensation in uterus, prostate, rectum, urethra, descending colon, lower intestine, and other pelvic organs despite taking oral pills.

Research studies have indicated that the treatment is also found to be highly effective to treat chronic, “incapacitating pelvic pain related to gynecologic, colorectal or genitourinary cancer.”

What Is a Superior Hypogastric Plexus Block?

The superior hypogastric plexus, a network of intersecting nerves, is positioned near the lower part of the spinal cord in front of the upper pelvis. It acts as a hub for transportation of sympathetic and parasympathetic nerves that percolate carrying sensation to pelvic and genital organs. Using injection to block the superior hypogastric plexus helps prevent pain sensation in the visceral and pelvic regions from being transmitted to the Sympathetic Nervous System and get significant relief.

Who Should Have Superior Hypogastric Plexus Block?

  • Superior hypogastric plexus block is beneficial for those suffering from significant pelvic pain and do not see any improvement despite taking painkiller pills.
  • With much lesser narcotic components, these injections offer significant relief against Superior Hypogastric Plexus Blockpremenstrual and other types of pain associated with endometriosis, a painful disorder caused by outgrowth of tissue membrane lining the uterus or even beyond the pelvic area, and formation of cysts.
  • Severe gynecological pain caused by chronic inflammation, interstitial cystitis, scar tissue development, or abnormal adhesion of abdominal or pelvic tissues can also be tackled with superior hypogastric plexus block injections.
  • Male and female patients with post-surgical chronic pelvic pain, irritable bowel syndrome, and pain following multiple gynecological surgeries may find these injections useful.

What Are Most Common Symptoms That Require Superior Hypogastric Plexus Block?

A patient can go for superior hypogastric plexus block if he or she continues to suffer from uncontrolled pain falling into any of the following categories.

  • Chronic pain associated with uterus, bladder, vulva, prostate, rectum, lower colon, urethra and pelvic organs.
  • Irrepressible pain in genital organs, including vagina, testicles, and penis.
  • Cancer pain caused by malignant cervical, prostate, testicular, and colorectal growth in the pelvic region.
  • Pelvic Inflammatory Disease or pain due to incessant infection
  • Perineal pain due to prostatitis or inflammation of the prostate gland
  • Painful menstruation or painful sexual intercourse due to preexisting medical issues
  • Myofascial pain syndrome impacting pelvic organs following connective tissue disorder, hyperirritability, emotional disturbance, or posture problems.
  • Pain originated due to pelvic fibrosis, congestion, or twisting of pelvic muscles.
  • Malignancy-associated anal-rectal pain
  • Pelvic pain secondary to radiation-induced neuropathy

What Is The Procedure of Superior Hypogastric Plexus Block?

superior hypogastric plexus blockAdvanced and minimally invasive, superior hypogastric plexus block procedure precisely targets a particular point that plays a crucial role in the transmission of painful sensation through the Sympathetic Nervous System. Categorized under the outpatient treatment, these injections are administered in a posterior approach – the patient lies down on his or her abdomen. Often Houston pain management doctors use intravenous sedation prior to the procedure.

An experienced Houston pain clinic doctor uses a fluoroscopy machine for greater accuracy. Two needles are used to reach both sides of the superior hypogastric plexus under fluoroscopic guidance and their correct placement is also determined using contrast dye injections. As soon as the placement is confirmed, doctors inject the medication.

What Is Injected During Superior Hypogastric Plexus Block?

Numbing medicine is used to offer immediate relief. Steroid medication is also often injected to provide longer relief.  Some doctors administer phenol to “deaden the nerves in the plexus” and prolong the pain relief.

How Long Does It Take?

The superior hypogastric plexus block procedure usually requires 30 to 45 minutes.

Do I Need Rest After Superior Hypogastric Plexus Block?

The procedure involves injecting steroid medication around the hypogastric plexus through your skin and tissues. Use of local anesthetic minimizes the pain and patients can go home. However, they are advised to have a short rest at home under family monitoring for any potential signs.

What Are The Benefits of Superior Hypogastric Plexus Block?

  • The superior hypogastric plexus block procedure is found to be highly effective in subduing persistent pelvic pain related to both malignancy and non-malignancy.pelvic pain2
  • Pain felt in various organs that are connected with the hypogastric plexus through afferent fibers can also be treated with these injections.
  • According to a 2005 study, at least 50 percent decrease in pain reduction can be achieved lasting for a month using this procedure. (Schmidt et al, Rev Bras Anestesiol 2005)
  • This also reduces the dependency on pills by 49 percent and on morphine use by 67 percent.
  • For cancer patients, the efficacy is about 72 percent pain control. (Plancarte R et al, Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesth. 1997)
  • The overall superior hypogastric plexus block success rate stands at 69 percent. (de Leon-Casasola et al, Pain 1992).

Are There Any Side Effects of Superior Hypogastric Plexus Block?

Theoretically, the procedure has risks similar to other injections, such as bleeding, temporary clots, or nerve injury. There may be anesthesia complications or even minor steroid drug side effects. Many have complained of sore back for a few days following the injection. In rarest of rare cases, it may result in large vessel puncture.

However, with modern fluoroscopy machine and advanced medical technologies in use with utmost precaution, any major injury risk is uncommon. Low chance of side effects and extremely efficacy in pain reduction encourage patients to go for the treatment every few months.

Should I Go For Superior Hypogastric Plexus Block Treatment?

If chronic pelvic pain continues to bother you and not controlled through conventional treatments, go for superior hypogastric plexus block. The procedure assures relief up to a month and you can repeat it for years. Make sure that the Houston pain management doctor is an experienced one.

http://bja.oxfordjournals.org/content/101/1/95.full

https://www.mc.vanderbilt.edu/documents/paineducation/files/NEUROLYTIC%20VISCERAL%20SYMPATHETIC%20BLOCKS.pdf

http://www.urmc.rochester.edu/imaging/patients/procedures/hypogastric-block.aspx

http://www.ncbi.nlm.nih.gov/pubmed/7784552