FAQ’s on Ganglion Impar Nerve Block

What is a Ganglion Impar Nerve Block?

The ganglion impar of the body is a bundle of nerves located within the coccyx (tail bone) that serves to provide sensation to the local tissues. When there is a complication within these surrounding tissues, namely in the pelvic or rectal regions, a ganglion impar nerve block can provide relief to the patient.

A nerve block injects a small amount of anesthetic into a nerve grouping in order to numb it, preventing the nerves from transmitting signals of pain to the brain thus obtaining some degree of relief.

What will a Ganglion Impar Nerve Block treat?

The ganglion impar block is able to treat any condition with symptoms related to the nervous activity of the nerve bundle. The ganglion impar has nerve fibers that protrude and provide sensation to the vulva, vagina, perineum, urethra, and anus meaning that for any of these areas, relief can potentially be obtained. For many patients, there will be a sense of bladder urgency or a burning sensation in the bladder in addition to pain felt in the abdomen.

How is a Ganglion Impar Nerve Block performed?

In order to perform a ganglion impar block, patients will be placed prone to provide the physician access to the ganglion impar through the back. The area to be injected through will be sterilized and numbed with local anesthetic, with the needle carefully inserted once the skin is numb. Needles will be guided into the nerve cluster through the use of fluoroscopic imaging, which is a series of rapid X-rays that create a current image of where the needle is within the patient.

Once the needle has been accurately placed within the block, the physician will inject a small amount of dye into the nerve cluster. This dye will cause the nerves to become visible on x-ray, confirming for the physician that the needle is in the correct place. Following this, the patient will be injected with either a small amount or a large amount of anesthetic.

The injection of a small amount of anesthetic is called a diagnostic nerve block, and provides the physician the ability to see how the nerves and the patient will react to full treatment. If there is a reasonably amount of relief provided, many physicians will then administer a full dosage of anesthetic – known as a therapeutic block.

How well do Ganglion Impar Nerve Blocks work?

Three possible results will occur following a nerve block:

  •  The first result is that the symptoms experienced by the patient simply do not change. While many patients will think of it as a failed block from it not providing relief, it is actually a useful diagnostic tool as it confirms that the ganglion impar is not the source of pain for the patient. This is important in reaching an accurate diagnosis of the real cause.
  •  The second possible result is that the symptoms may fade for a small amount of time only to return. This is another useful diagnostic tool, as it confirms that the ganglion impar is the source of the pain for the patient. The problem with this block lies within the steroidal component, as the returning of symptoms means that the steroid failed to extend the duration of relief.
  •  The third, and best, outcome is that the symptoms fade, return briefly in a much weaker form, then dissipate over the next few days and remain gone. This means that both the anesthetic and the steroid components of the injection worked, and means that the therapeutic block was successful for the patient.

What are the risks of a Ganglion Impar Nerve Block?

There is the standard small risk of infection, bleeding, or swelling at the injection site. There is also a chance of allergic reaction to the agents used. Patients will be monitored following their injection to ensure this does not occur. The largest risk with this procedure is that it simply will not work.