A hypogastric plexus block is a minimally invasive injection procedure that helps relieve chronic pelvic pain. The hypogastric plexus is a group of nerves located near the bottom of the spinal cord that helps transport sensory signals to the pelvis. This procedure is usually performed on patients who suffer from pelvic pain conditions such as endometriosis, irritable bowel syndrome, or cancer of the colon, bladder, lower intestines, and reproductive organs. The efficacy of this procedure varies, but generally speaking, patients may experience pain relief that lasts weeks, months, or years. If a patient’s pain does return, a hypogastric plexus block can be performed every three to four months. This procedure may be recommended to patients who have not experienced sustained pain relief from oral medications and other conservative therapies.
Patients begin the procedure lying face down with their lower back exposed. Shortly thereafter, the patient is given a sedative intravenously to minimize his or her discomfort throughout the procedure. The physician then numbs the injection site with a local anesthetic before using x-ray guidance to insert two needles into the back near each hip bone. As the needles advance toward the superior hypogastric plexus, a contrast dye is injected to ensure accurate needle placement. Once the location of the damaged hypogastric plexus nerves is confirmed, the physician injects the pain medication into the superior hypogastric plexus. The injection usually contains a steroid for long-term pain relief, and either an alcohol or phenol, to destroy damaged nerves. After the pain medication is injected, the surgical sites are then bandaged and the patient is sent to separate room to recover.
The patient’s vitals (i.e. pulse, temperature, oxygen levels, and blood pressure) are monitored immediately after the procedure to ensure their health and safety. Once the sedative wears off and the patient is cleared by the physician, he or she may return home. While a hypogastric plexus block is effective at treating chronic pelvic pain, there are some risks associated with the procedure. Although rare, patients may experience bleeding, infection, nerve injury, partial paralysis, or increased pain from a hypogastric plexus block. Patients should contact their Orthopedic and Wellness physician immediately if they experience any of these symptoms.