The hypogastric plexus is a bundle of nerves near the bottom of your spine. Blocking these nerves from carrying pain information can help you stop feeling pain in your pelvis. Hypogastric Plexus Blocks are minimally-invasive injections of medication that help relieve lower abdominal and pelvic pain. The pain may come from the colon, bladder, lower intestines, uterus or ovaries, prostate or testicles, or other parts of the pelvis. The procedure also can help reduce pelvic pain from endometriosis, irritable bowel syndrome, radiation injury and cancer in the pelvis. Oral medication is variably effective against the above conditions – these injections may give you more relief while taking less pain medication.
Hypogastric blocks are done as an outpatient procedure and can be done in a Clearway Surgery Center – with sedation (twilight sleep) if desired. During the procedure, your doctor will numb an area of skin on your back with a local anesthetic. Then, guided by an x-ray, he or she will: 1. Insert two needles into your back, near each hip bone 2. Under careful Live Xray guidance the needles will be positioned in the correct area 3. Inject dye to confirm that medication will go to the correct spot 4. Inject pain medication, including a steroid for longer-term relief; alcohol or phenol also may be injected to destroy the nerves Hypogastric blocks may include a series of injections, repeated at weekly intervals.
Patients may experience pain relief within 30 minutes after the injection, but pain may return a few hours later as the anesthetic wears off. Longer term relief usually begins in two to three days, once the steroid begins to work. How long the pain stays away is different for each patient. For some, the relief lasts weeks. For others, the relief lasts years. If the pain returns, you can have a repeat injection every few months.
Serious side effects and complications are uncommon. The most common side effect is pain and soreness at the injection site. Uncommon risks include infection, nerve damage, hypotension and bleeding.