Hypogastric plexus block

Overview

A hypogastric plexus block is a pain-relieving injection administered into a bundle of nerves located near the bottom of the spine. By blocking the hypogastric plexus, the injection prevents these nerves from transmitting pain signals from the pelvic area, effectively reducing pain in the lower abdomen. Depending on individual needs, a single injection may suffice, or a series of injections may be provided by a healthcare provider.

Types

There are two types of hypogastric plexus blocks based on the location:

• Superior hypogastric plexus block
  • Location: Upper part of the hypogastric plexus in the lower back.
• Inferior hypogastric plexus block
  • Location: Lower part of the hypogastric plexus near the tailbone.

Your healthcare provider will inject medication into a specific part of the nerve plexus, depending on the source of pain.

Reasons for undergoing the procedure

There are several possible locations where the pain could come from, including the colon, bladder, lower intestines, uterus, ovaries, prostate, testicles, or other areas of the pelvis. This procedure can also alleviate pelvic pain associated with conditions like endometriosis, radiation injury, and cancer.

In the event that your pelvic pain is severe and not improved by taking oral medicine, you might require a hypogastric plexus block.

Risk

Complications from a hypogastric plexus block are rare but may include bruising or soreness at the injection site, which typically resolves within a few days. Serious complications such as infection, nerve damage, or bleeding are uncommon.

The following side effects of the steroids are rare but may include:

• Abdominal cramping or bloating.
• Fever.
• Flushing of the face.
• Headache.
• Hiccups.
• Increased appetite.
• Increased heart rate.
• Insomnia.
• Water retention.

These side effects typically resolve within a few days.

Procedure

First, you may be given an intravenous medication to relax you. Then, you’ll lie on your stomach on an X-ray table. Your healthcare provider will numb an area of skin on your back with a local anesthesia.

Your healthcare provider will carry out the following procedures under the guidance of an X-ray:

• Position needles near your hip bone on your back.
• Injecting dye is essential to verify that the medication reaches the intended location.
• Administer pain relief medication, this may include steroid. Additionally, in certain instances, alcohol or phenol may be injected to target nerve destruction.

The procedure typically lasts around 30 minutes, followed by a minimum 30-minute observation period. Most individuals are discharged shortly thereafter.

Outcome

A hypogastric plexus block can provide substantial relief, potentially reducing your reliance on pain medication. This treatment is particularly beneficial for individuals suffering from severe or chronic pain.

In addition to less pelvic pain, you might feel warmer or notice a shift in sensation in your pelvic region. Although the anesthesia wears off after a few hours, certain individuals report pain alleviation as fast as thirty minutes following the injection. As the combination medication and anesthesia take effect, long-term relief usually starts in two to three days.

The duration of pain relief varies for each patient. For some, relief can last weeks, while for others, it may extend for years. If the pain recurs, you can consult your healthcare provider to explore the option of undergoing another hypogastric plexus block.

After the procedure, you can return to your regular diet and medications. However, avoid driving or engaging in strenuous activities for 24 hours. You should be able to resume your usual activities the next day.

Discussing this option with your healthcare provider might help you manage your pain more effectively and enhance your daily quality of life. If you experience increased pain or if the pain persists, please contact your healthcare provider without hesitation.