FAQ\’s on Superior Hypogastric Plexus Block
Why does a patient choose to do a Superior hypogastric plexus block?
Superior hypogastric plexus block is a procedure performed to alleviate pain (resulting from malignant or non-malignant causes) in the pelvic region. This treatment can be performed to patients for whom oral medication is ineffective or has unbearable side effects. The Superior hypogastric plexus is a region in the lower back where there are numerous nerves linking to the organs in the pelvic region and administering block in this region would provide relief to pain originating from any of the linked organs or pain from cancerous tissues.
How is the Superior hypogastric plexus block procedure performed?
This procedure is minimally invasive and can be performed in one of three ways – posterior, anterior or transdiscal approach. Posterior approach is the most commonly used method while the remaining two are used for patients who have certain complications such as unease or difficult posture. In the posterior approach, the patient will be asked to lie down on his abdomen and a pillow will be placed under the patient\’s pelvis to aid in the treatment. Then, the patient\’s skin will be sterilized and anaesthetized carefully, after which two six inch needles will be inserted at two points in the skin. In order to make sure that the needles are positioned properly, the doctor will use fluoroscopic guidance (a radiation free imaging method).
Once the needles are placed, their position will be confirmed by using contrast dye and then blocking will carried out by the doctor. The entire procedure of a Superior hypogastric plexus block will be completed within 15 minutes.
How long do the Superior hypogastric plexus block injections last?
The duration for which the drugs last depends upon individual patients. It varies greatly from few weeks to even years. Mostly, the relief is temporary for the patients and if the first procedure was successful, repeated procedures at definite intervals can be carried out, thereby reducing the oral drug consumption for patients by seventy percent.
What are the risks or side effects are there with a Superior hypogastric plexus block?
The risks associated with this procedure are very minimal. In fact, in a study conducted among 200 patients, who were administered this block, none reported any problems in their neurological function. However there can be certain risks, even though they have not manifested much in the treated patients. Wrongful placement of needle harms nearby tissues and causes nerve damage, paralysis, etc. Direct injection into the blood vessels can cause drug allergy and seizure. Also there are chances of infection since needle penetration is involved at the injection site.
This procedure is used for treating pain arising from the pelvic areas such as urethra, bladder, vagina, vulva, uterus, perineum, descending colon, rectum, prostate and testes. It is especially effective for those who suffer from pelvic cancer (cervical, prostate, testicular), radiation injury or endometriosis. Also, it can be administered in a combined manner with other blocks such as ganglion impar block.
How successful are Superior hypogastric plexus blocks for the relief of pain?
There is no exact time period for which all the patients will be relieved from their pelvic pain. The results differ for each individual, some may experience relief for weeks while others may experience it for years. In addition, the degree of pain also varies, from zero pain to tolerable levels. The important thing here is that blocking the superior hypogastric plexus is certainly a beneficial and effective treatment on average for patients with symptomatic pelvic pain.