Most doctors believe that chronic pain in the visceral and pelvic regions is often caused by vulvitis, pelvic fibrosis, prostatitis, irritable bowel syndrome, radiation-induced neuropathy, and myofascial pain syndrome. The superior hypogastric plexus is a component of the sympathetic nervous system that is responsible for communicating the pain from the pelvic regions to the central nervous system. By blocking the superior hypogastric plexus with the necessary injections, one can experience substantial pain relief in the visceral and pelvic areas.

What is a Superior Hypogastric Plexus Block?

Commonly referred to as a hypogastric block, a superior hypogastric plexus block is an innovative and minimally invasive procedure that is used to relieve pelvic and genital pain. The uniqueness of this advanced procedure lies in its efficiency in treating pain from a multiple different origins such as the structures of the pelvic region that are innervated by the inferior hypogastric plexus, genitofemoral nerve, superior hypogastric plexus pudendal, celiac plexus, and the inguinal.

How Does the Procedure Work?

Performing the superior hypogastric plexus block is typically a two-step process, especially with patients who are portraying nonmalignant pain symptoms. In most cases, the physician will perform the diagnostic block first, which consist of injecting a local anesthetic such as lidocaine or bupivacaine to access the pain’s response to a block of the superior hypogastric plexus. If the patient is demonstrating a response to the diagnostic block, the physician will then perform the therapeutic block by administering a neurolytic agent like dehydrated alcohol or phenol. Superior hypogastric plexus injections should always be performed under the careful guidance of a well-qualified pain management specialist.

Who is a Good Candidate for the Superior Hypogastric Plexus Block?

Most physicians recommend superior hypogastric plexus injections for those who are continually suffering from severe chronic pelvic pain despite their efforts to relieve the pain through oral medications, physical therapy, and other traditional therapies. Because the procedure is considered to be more effective than a sympathetic block, most patients will experience great relief from the injections for several months. This treatment may also help those who have been diagnosed with pudendal neuralgia.

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For those who suffer from severe perineal pain, a ganglion impar injection may be the perfect procedure to alleviate their discomfort.

What is a Ganglion Impar Injection?
The purpose of a ganglion impar injection is to manage chronic pain in the genital, pelvic, visceral, perineal, and anal areas. Many of the candidates of this procedure frequently complain of a burning sensation with urination and/or defecation. The ganglion impar injection will stop the discomfort that is linked to the bundle of nerves that are receiving the pain.

How does the Procedure Work?

The ganglion impar injection is performed with the patient laying face down. The doctor will most likely place a pillow under the patient’s pelvis to ensure that the lower back resembles a flat surface. Next, the area of injection is numbed with local anesthetic. The doctor then uses fluoroscopy to guide the needle into the ganglion impar, which is a bundle of nerves that receives the pain associated with the distal urethra, vulva, perineum, and distal rectum.

There are two different types of blocks that may be used to treat the pain in the ganglion impar area.

Diagnostic Block: These blocks are primarily used for non-cancer related pain. The procedure consist of a steroid injection to ensure that the ganglion impar is really causing the patient severe discomfort. A diagnostic block is typically performed twice.

Therapeutic Blocks: These blocks use a neurolytic agent to treat the pain at the source. Therapeutic blocks are usually performed only once.

A ganglion impar injection is typically 15 minutes, and most people inform their doctors that the pain relief has lasted many weeks and even years.

What are the Potential Benefits?

As a minimally invasive procedure, the ganglion impar injection can be performed in the doctor’s office. Because there are numerous pelvic structures that have nerve fibers that travel through the ganglion of impar, a block performed in this area can treat many areas of pain simultaneously. After the procedure, most patients can expect between 50 to 100 percent pain relief from the injection.

If you are reading this on any other blog than Comprehensive Pain Management Center or via my RSS Feed, it is stolen content without credit. You can find us  on Twitter via @CompPainMgmt. Come and visit our blog at http://www.compainmc.com/blog/.