FAQ’s on Superior Hypogastric Plexus Block
What is a Superior Hypogastric Plexus Block?
The superior hypogastric plexus is a nerve bundle that provides sensation to the surrounding tissues and structures of the pelvis. It is located in close proximity to the area where the end of the spine meets the sacrum. Patients who are experiencing symptomatic pain from their intestines, prostate, uterus, bladder, or other local tissues may be able to effectively obtain relief with a superior hypogastric plexus block. The block can also be a successful treatment for patients experiencing pain due to certain types of pelvic cancer.
What will a Superior Hypogastric Plexus Block treat?
The block is designed to provide relief to any area of the pelvis that has sensation
provided to it by the superior hypogastric plexus. Blocking the nerves of this plexus can assist patients in treating symptoms associated with their uterus, bladder, prostate, intestines, or deferred pains associated with cancer. Superior hypogastric blocks can also be very effective to patients with visceral pelvis pain according to extensive research (Blockade of the superior hypogastric plexus block for visceral pelvic pain, 2001)
Nerve blocks administered to the superior hypogastric plexus can be especially beneficial to patients who are not actively responding sufficiently to oral medications. Blocking the nerves can potentially negate the requirement of medication, but is more likely to reduce the levels required for symptomatic management.
The superior hypogastric block has been clinically tested for its effectiveness in both noncancer pelvic pain (Computed tomography-guided anterior approach to the superior hypogastric plexus for noncancer pelvic pain, 2005) and for pain directly caused by pelvic cancer (Efficacy of the anterior ultrasound-guided superior hypogastric plexus neurolysis in pelvic cancer pain, 2013).
How is a Superior Hypogastric Plexus Block performed?
There are two primary purposes behind performing a superior hypogastric plexus block: as a diagnostic tool, and as a therapeutic treatment. To receive the block, patients will be asked to lie prone and will typically be sedated intravenously. The most common method by our clinic for injection is a bilateral approach, which uses one needle on each side of the plexus (nerve cluster) to reliably be able to reach the full plexus during injection. Fluoroscopic imaging (a series of rapid X-rays taken to create a real time image) will be used to ensure the accuracy of needle placement.
Patients receiving a diagnostic nerve block will be given only a small amount of numbing agent which will temporarily stop the transmission of signals from the hypogastric plexus. If a patients symptoms cease, it is very likely that the superior hypogastric plexus is the main cause of their pain and that a therapeutic block will be able to alleviate pain relief.
Patients receiving a therapeutic block will be given a much larger amount of anesthetic during the injection process, and will also receive a supplemental steroid to prolong the effect of the anesthetic used. Patients should expect the injection process to take no longer than one hour, and have no required recovery time following treatment.
How well do Superior Hypogastric Plexus Blocks work?
There is a very good chance for patients receiving this block to obtain symptomatic relief, as over 70% of our patients see a reduction in their pain. The average levels of reduction are 50% in pain, and a 40% lowering of the opiates required to maintain pain relief. The duration of relief will differ on a patient to patient basis, and has been known to last multiple years for some patients. The typical duration is one month, with the ability to repeat the block as needed to maintain long-term relief.
What are the risks of a Superior Hypogastric Plexus Block?
This procedure is a very safe one for patients due to the reliability of the guidance techniques used for needle placement. There is a small risk of bleeding, infection, pain, or allergic reaction at the site of the injection.