FAQ’s on Superior Hypogastric Plexus Block
What is a Superior Hypogastric Plexus Block?
The superior hypogastric plexus is a cluster of nerves located where the sacrum meets the end of the spine. This plexus serves to provide nervous connections to the pelvis, with nerve paths to both the surrounding organs and bodily structures.
When there is pain in the lower abdomen or pelvis, it is often the result of a complication with the superior hypogastric plexus. Blocking this nerve group can help to provide relief to the patient for many conditions of the pelvis.
What will a Superior Hypogastric Plexus Block treat?
A nerve block to the superior hypogastric plexus can help provide relief for any condition of the pelvis and lower abdomen that is being caused by these nerves. This block has applications for the symptoms of problems with the prostate, uterus, bladder, intestines, and lumbar spine.
For a large number of patients, this block is used to supplement the opiates they are receiving as treatment. This is due to the opiates not being able to completely treat pain in the soft tissue or organs, whereas a nerve block will stop the transmission of pain signals completely. In many cases, this block will also assist the patient by reducing the amount of opiates required to obtain pain relief.
How is a Superior Hypogastric Plexus Block performed?
Superior hypogastric plexus blocks are performed as outpatient procedures with the patient in the prone position while under IV sedation. Fluoroscopic imaging will be used will be used to ensure the injection needle is guided accurately into the plexus. This imaging is a series of X-rays to create a current picture of where the needle is within the patient, and is crucial in ensuring accuracy of the injection.
Once the needles have been placed within the nerve, a numbing agent is injected. This inhibits the transmission of pain signals from that nerve to the brain, directly creating a window of relief for the patient. Most injections also have a steroidal component which serves to extend the duration of the injection. Many physicians will opt to use a bilateral approach with their patient, which makes the use of a needle on each side of the plexus in order to guarantee that the entirety of the nerve cluster receives the numbing agent used.
How well does a Superior Hypogastric Plexus Block work?
This block is an effective treatment method for many patients, as over 70% of blocks administered are successful in providing some degree of relief. Of these successful blocks, about 50% are able to provide extended relief for the patient with many patients able to reduce their opiate intake by upwards of 40%. The exact length of relief that can be obtained is still subject to inquiry, as the length of relief can vary wildly between individual patients. Relief provided for the patient can range from only a handful of weeks to multiple years, again with wide fluctuation from patient to patient. For many, the relief provided will last only about one month at which point the nerve block can be repeated.
What are the risks of a Superior Hypogastric Plexus Block?
There is very little risk associated with a superior hypogastric plexus block. As it is a needle-based treatment, there is a small risk of bleeding, swelling, or infection at the injection site. There is the risk of nerve injury or unintentional anesthetic application if the injection needle happens to be misplaced, but this is rare due to the use of fluoroscopic imaging. The patient will be monitored following the injection to ensure there are no adverse reactions to the treatment.
What is the bottom line with Superior Hypogastric Plexus Blocks?
These blocks can be very useful for those patients who are not finding adequate relief with opiates alone. The success of the superior hypogastric plexus block is largely dependent on the skill of the physician.