Let’s look at the basics first. Superior Hypogastric plexus blocks have been found to be very effective in eliminating pain caused by recurrent pelvic pain. And this could be used to treat pain that rises from the prostrate, uterus, ovaries, bladder, lower intestines, testicles and other pelvic regions.
The plexus is a term used to refer to a set of nerves. A superior hypogastric plexus is a set of nerves that is found before the region where the sacrum joins the lumbar spine.
This set of nerves typically is what helps receive signals in a certain part of the pelvis. Any injections administered to the plexus can therefore help eliminate the pain experienced throughout the pelvis.
A main problem that comes with the treatment of pelvic pain using narcotics is that they do not usually help to contain the pain in the region. Plexus injections may therefore be require in order to alleviate the pain to a greater extent and there should be subsequent lowering in the opiate medicines that are taken.
A superior hypogastric plexus block may be used to help eliminate pain caused by interstitial cystitis, irritable kind of bowel syndrome, endometriosis, Adesions after pelvic surgery, or after a prostatectomy. Both men and women can find relief using this method of treatment.
The patient will need to come into the hospital and lie on their belly. They may or may not be anaesthetised during the procedure. Localised desensitisation of the area may be sufficient for the procedure, also.
The pain doctor will use X rays to guide the injection to the right part of the pelvis, in a method called fluoroscopy. This helps to correctly guide the injection to the exact area where the pain has emerged, and involves the use of two needles.
The needles are guided into position from the left side and the right side of the plexus. The pain doctor will then administer shots from either needle alternatively to ensure the positioning is done correctly. The injection will contain a desensitising medication like lidocaine and a steroid. Some pain doctors prefer the use of phenol instead of using cortisone. Phenol is a type of alcohol that numbs the plexus nerves so that the pain is eliminated for a longer time.
The entire treatment takes anywhere between 30 to 45 minutes to be completed. The patients are then observed in the outpatient room for an hour or so to ensure that their vital signs are responding as normal and there has been no allergic reaction to the medication.
A superior hypogastric plexus block has several advantages. There have been reported to be more than 50% of pain reduction and the need for opiates usually reduce by 40% and this effect is sufficient for a whole month literally (Schmidt et al, Rev Bras Anestesiol 2005).
The success rate for this method is around 70% as per a study (de Leon-Casasola et al, Pain 1992). Certain individuals find that they do not experience pain even after years of receiving the injection. In case the pain returns within a couple of months, the same procedure can be repeated for more effective pain relief.
There are normally no risks involved with this method of treatment. There can be instances of a bit of bleeding, infection, nerve trauma or issues with the way the anesthesia is administered. There could also be a short term rise in blood sugar level or the person may experience increase in weight due to the cortisone. This is only a temporary condition. There is also the rare risk that a major vessel could get punctured in error.
Superior type of hypogastric plexus blocks have been very successful in the treatment of pelvic pain. These injections are especially useful for the treatment of pain after surgery, irritable kind of bowel syndrome, endometriosis and other sources of pelvic pain in men and women.