Ganglion Impar Injection

A ganglion impar injection is used to manage chronic perineal pain. The ganglion impar is a bundle of nerves that receives the pain associated with the perineum, distal rectum, anus, distal urethra, vulva, and distal third of the vagina. The ganglion impar injection is a steroid injection used to numb the nerve and stop the pain linked to the nerve.

This procedure is performed with the patient laying face down. A pillow is placed under the pelvis to smooth out the curve of the lower back. The point of the injection and some of the surrounding area is prepped with local anesthetic to numb the area. The physician then uses fluoroscopy to guide the needle into the right position.

Two different types of blocks may be used at this point, a diagnostic block or a therapeutic block. Diagnostic blocks are mainly used for non-cancer related pain and involve a steroid injection to test if it is really the ganglion impar causing the pain while therapeutic blocks use a neurolytic agent. The procedure is often less than 15 minutes and patients report pain relief lasting anywhere from weeks to years.