FAQ’s on Superior Hypogastric Plexus Block in Las Vegas

The superior hypogastric plexus block is useful for offering pain relief for organs and body regions supplied by the superior hypogastric plexus nerves. These nerves are located near the lower spine and sacrum. The bundle of nerves offer sensation to the lower abdomen and pelvis structures and organs.

How long does the superior hypogastric plexus block take to perform?

The procedure only takes approximately 15 minutes to perform. However, you should plan to be at the medical facility for 1-2 hours, which includes check-in, work-up, procedure, and recovery time.

What conditions are treated with the superior hypogastric plexus block?

The superior hypogastric plexus block is used to treat many disorders and cancers of the intestines, uterus, bladder, and prostate. Additionally, the block can help with chronic pelvic pain, chronic pancreatitis, functional abdominal pain, and prostate cancer pain.

Does the superior hypogastric plexus block hurt?

A local anesthetic is used to first numb the skin before the injection. Expect to feel a slight burning and pinching sensation. Most patients report only feeling pressure when the actual block injection is given. There may be some slight soreness at the injection site after the procedure, but this only lasts for 24-48 hours. We recommend using ice packs to alleviate the discomfort.

What should I do to get ready for the procedure?

Because a mild sedative is used during the block, you cannot eat or drink after midnight. However, necessary medications can be taken with small sips of water before you leave home. Discuss any blood-thinning agents with the doctor, as these must be held for 3-7 days beforehand. Bring someone to drive you home, wear loose fitting clothes, and leave all jewelry at home. When you arrive at the medical facility, the nurse goes over the procedure pros and cons and has you sign a consent form. The nurse places an IV catheter in your arm, and monitoring devices are used to check heart rate, blood pressure, and oxygen level.

How is the superior hypogastric plexus block performed?

The doctor will position you on your stomach, using pillows to support the abdomen and pelvis. The skin of the back is anesthetized, and real-time x-ray is used to insert the procedure needles near the nerve bundle. A long-acting anesthetic, and sometimes, a neurolytic agent, is injected onto the nerves.

What happens after the procedure?

Once the procedure is done, a nurse monitors the patient in recovery for around 25 minutes. The nurse will ask questions regarding the patient’s pain. We recommend that you take it easy for the rest of the day, and avoid any heavy activities for 1-2 days. Gradually return to normal duties as tolerated. Do not soak in a tub or pool for a few days.

Does the superior hypogastric plexus block work?

According to clinical studies, the success rate of the superior hypogastric block is 70-90%. In recent research trial involving 32 patients, more than half reported total pain relief. For patients with bladder cancer, the efficacy rate is around 89%, with decreased use of pain medications and improve functional status.

What side effects and risks are associated with the block?

All minimally invasive procedures carry certain risks, but complications rarely occur. However, these include bleeding, injection site pain, nerve injury, infection, and allergic reaction. Medication side effects include dry mouth, drowsiness, dizziness, and confusion.

Resources

Kroll, CE, Schartz, B, Gonzalez-Fernandez M, et al. (2014). Factors associated with outcome after superior hypogastric plexus neurolysis in cancer patients. Clinical Journal of Pain, 30(1), 55-62.

Mishra S, Bhatnagar S, Rana SP, Khurana D, Thulkar S. Efficacy of the anterior ultrasound-guided superior hypogastric plexus neurolysis in pelvic cancer pain in advanced gynecological cancer patients. Pain Med. 2013;14(6):837-842.

Schmidt AP, Schmidt SR, Ribeiro SM. Is superior hypogastric plexus block effective for treatment of chronic pelvic pain? Rev Bras Anestesiol. 2005;55(6):669-679.