A superior hypogastric plexus block is an option for providing relief from pelvic pain when other pain management methods have failed. It is a minimally invasive procedure helpful for treating pelvic and genital pain.

What Is the Superior Hypogastric Plexus?

The superior hypogastric plexus (previously called the hypogastric plexus or presacral nerve) is a branching network of nerves found near the base of the spine between the fifth lumbar vertebra and the third sacral vertebrae. It is in front of where the abdominal aorta splits into the left and right iliac arteries to supply blood to the lower portions of the body.

This network of nerves is a part of the sympathetic nervous system and is responsible for transmitting subconscious sensations to and from the body’s pelvic region. When chronic pain develops in the pelvis, the superior hypogastric plexus is a source of pain signals sent to the brain.

What Is a Superior Hypogastric Plexus Block?

A superior hypogastric plexus block (also known as a hypogastric block) is an advanced, minimally invasive procedure for treating pelvic and genital pain. The block is an injection of a pain-killing medication to this network of nerves. It is an outpatient procedure, and most patients do not require IV sedation.

The duration of the pain relief will vary from patient to patient. Most patients experience pain relief within the first 15 to 20 minutes after the injection. However, if a steroid medication was also included in the injection, full pain relief may not begin until about 36 hours after the injection.

The injections are a more precise version of a sympathetic block targeting the superior hypogastric plexus region of the sympathetic nervous system. This network of nerves is a part of the sympathetic nervous system that can communicate pain to the central nervous system even when there is no damage or inflammation to the area.

A superior hypogastric plexus block can be helpful for those suffering from chronic pelvic pain, genital pain, or pain originating in the main pelvis nerve (pudendal nerve). The superior hypogastric plexus block is a pain treatment option to consider when oral medications and other conventional treatments have failed to relieve the pain.

Conditions Treated with a Superior Hypogastric Plexus Block

A superior hypogastric plexus block is often helpful in treating pain caused by the organs within the pelvis, such as the uterus, cervix, vagina, bladder, prostate, and rectum. A pain originating from an organ within the body is called visceral pain, a type of pain that is often constant and deep. Visceral pain can radiate (spread) rather than being isolated to a single spot in the body.

Some of the types of pain treated with a superior hypogastric plexus block include:

Bladder.
Cancer pain.
Chronic low abdominal or pelvic pain.
Cystitis.
Dysmenorrhea (painful menstruation).
Dyspareunia (painful intercourse).
Endometriosis.
Injury to the pelvis from previous surgery.
Interstitial cystitis (a chronic condition that causes bladder pressure and pain).
Irritable bowel syndrome.
Myofascial pain syndrome.
Ovarian, cervical, endometrial, or uterine pain.
Pain due to adhesions resulting from abdominal surgery.
Pelvic congestion.
Pelvic fibrosis.
Pelvic inflammatory disease.
Pelvis neurodystonica (a combination of neural dysfunction and abnormal tone in the pelvic region).
Prostate or colon pain.
Radiation-induced neuropathy.
Sympathetically-mediated pain (complex regional pain syndrome).
Varicocele (an enlargement of the veins within the scrotum).
Vulvitis (an inflammation of the vulva).

How Is a Superior Hypogastric Plexus Block Used?

This procedure can be used as a diagnostic block or a therapeutic block. In most cases (especially in nonmalignant pain syndromes), a superior hypogastric plexus block is performed initially as a diagnostic block.

Diagnostic Block. An injection of a local anesthetic (Lidocaine or Bupivacaine) as a test to see if the pain responds to the block.
Therapeutic Block. For patients who respond to the diagnostic block and experience a temporary decrease in pain and symptoms, a therapeutic block often follows to administer a medicine that temporarily deadens the nerves.

For chronic pelvic pain that has failed to resolve with medications, physical therapy, and other conservative therapies, a superior hypogastric plexus block procedure may be a viable pain management option.

Novus Spine & Pain Center

Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including a superior hypogastric plexus block. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.

For your convenience, you may schedule an appointment online, request a call back, or call our office at 863-473-7849.