Hypogastric Plexus Nerve Block
A hypogastric plexus nerve block is a minimally invasive pain management procedure that targets the hypogastric plexus, a bundle of nerves located at the base of your spine. These nerves transmit pain signals from the pelvic organs, such as the bladder, uterus, prostate, rectum, and other nearby structures.
By injecting a local anesthetic, sometimes combined with a steroid or other medication, into the area around the hypogastric plexus, physicians can temporarily block or reduce pain signals.
Who Benefits from a Hypogastric Plexus Nerve Block
A hypogastric plexus nerve block may be considered if you experience:
- Chronic pelvic pain that has not responded well to conservative treatments
- Cancer-related pelvic pain (such as from cervical, rectal, or prostate cancer)
- Pain from endometriosis, interstitial cystitis, pelvic adhesions, or other gynecological/urological disorders
- Lower abdominal pain related to pelvic organ dysfunction
- Pain that interferes with daily functioning, mobility, or quality of life
This treatment is often considered when medications, physical therapy, or less invasive measures are not providing adequate relief.
What to Expect
- Preparation: You may be asked to fast for several hours before the procedure. An IV line may be placed for sedation and monitoring.
- Positioning: You will typically lie on your stomach or side.
- Imaging Guidance: The physician uses fluoroscopy (live X-ray) or CT guidance to precisely place the needle into your back, near the hip bone.
- Injection: A small amount of local anesthetic is applied first to numb the skin. Then, a thin needle is advanced to the target area and dye is injected to ensure the medication will reach the desired area. Then, the medication (anesthetic, steroid, or neurolytic agent) is injected.
- Duration: The procedure usually takes 30 minutes, plus 30 minutes of recovery.
- Outpatient: Patients return home the same day.
After the Procedure
- Your pelvic area may feel warm or “different.”
- Immediate Relief: You may experience pain relief within minutes if a local anesthetic is used. This effect may be temporary and is often used as a diagnostic test.
- Ongoing Effect: If a steroid or neurolytic medication is used, longer-term relief may develop over the next 2-3 days.
- Soreness: Mild discomfort, bruising, or soreness at the injection site is common for a few days.
- Monitoring: You will be observed briefly after the procedure before being discharged.
Recovery and Aftercare
- Activity: Light activity is generally allowed the next day, though you may be asked to rest the day of the procedure.
- Return to Work: Many patients return to normal activities within 24–48 hours, depending on their overall condition.
- Physical Therapy or Rehabilitation: Your doctor may suggest combining the procedure with therapy or other treatments for optimal results.
How Long Do Results Last?
Pain relief for each patient varies for some, the relief lasts weeks. For others, the relief lasts years. If the pain returns, you can discuss having another hypogastric plexus block with your healthcare provider.
Risks and Considerations
While generally safe, possible risks include:
- Temporary increase in pain
- Bleeding or infection at the injection site
- Nerve irritation, numbness, or weakness (rare)
- Low blood pressure or urinary changes (due to nerve involvement)