Hypogastric Plexus Blocks

The hypogastric plexus is a bundle of nerves present near the distal end of the spinal cord. The nerves transfer pain impulses from the organs around the pelvic region, such as the bladder, rectum, descending colon, perineum, uterus, vagina, vulva, prostate, testes and penis. Blocking these nerves from carrying pain signal helps relieve pelvic pain. Hypogastric plexus block anesthetic injections are targeted at the hypogastric plexus. It is considered when oral medications either do not help relieve the pain or cause adverse side effects. The block is indicated for pain caused by endometriosis, radiation injury or cancers in the pelvic regions.

During the hypogastric plexus block procedure you will lie on your stomach on an X-ray table. Your doctor will numb the area on the back with local anesthesia. Then with the help of fluoroscopy (live X-ray), your doctor will insert 2 needles, near each hip bone. Your doctor then injects a dye to track the path of the medication. The medication (steroids, alcohol or phenol) is then injected to block the targeted nerve. This procedure usually takes about 30 minutes. You will be under observation for 30 minutes, and can then go home. Avoid driving and rigorous activities for that day. Your regular activities can be resumed the next day.

As with most invasive procedures, hypogastric plexus block may be associated with certain risks that are rare; these include bruising or soreness, infection, bleeding, nerve damage, flushed face, fever, insomnia, headache, increased appetite and heart rate, abdominal cramping or water retention. These side effects usually resolve within a few days.

Some patients may experience pain relief 30 minutes after the procedure; however, pain may return once the anesthetic wears off. You may experience long-term relief in 2 to 3 days after the procedure. Pain control may last from a few weeks to a few years. If pain returns the block can be repeated.