Hypogastric Plexus Block

What is Hypogastric Plexus Block?

Hypogastric Plexus Block

Hypogastric Plexus Block is a common technique in nerve block and pain management. A nerve block is a procedure provided for patients experiencing chronic pains. This procedure often provides lasting solutions to prolonged internal pains.  Hypogastric Plexus Block is a kind of nerve block that helps relieve pains around the pelvic region.

The pelvis is a compound bone structure at the base of the spinal cord that supports the legs. It consists of the hipbone, sacrum and coccyx. The pain may not particularly start from the bony region; it could be from the intestines, testicles, ovaries, colon, or bladder

What is Hypogastric Plexus Nerve?

Hypogastric Plexus Nerves are a collection of nerves located at the base of the spine. It also covers the lower part of the abdomen. These nerves are responsible for controlling organs in the pelvic region.  However, hypogastric plexus nerves are sympathetic nerves. This means they do not usually send pain signals to the brain except in severe or exceptional cases. The nerves innervate the vagina, rectum, testicles, rectum, uterus, pelvic cavity and vulva.

What kind of pain is treated with Hypogastric Plexus Block?

Hypogastric Plexus Block is required to treat the following kind of pains:

  • Chronic Pelvic Pain

Hypogastric Plexus Block

This is pain that is capable of making a patient unable to bend, sit or twist properly. The pains are felt both on the bones and when the muscles around it are stressed.

  • Testicular Cancer Pain

These are pains originating from the testicle region; it could be a result of an infection or cancerous cells.

  • Radiation Injury

These are micro-injuries sustained when exposed to excess radiation.

  • Endometrial Pains

These are pains originating from the uterus as a result of infection or inflammation of the mucus membrane lining the uterus.

  • Chronic Pancreatitis

These are pains from the pancreas; this is as a result of swelling of the pancreas due to dysfunction, poisoning, or infection.

What are the procedures required when taking a Hypogastric Plexus Block medication?

Hypogastric Plexus Block

  1. It is expected that the doctor performs some diagnosis, checks the medical history of the patient and allergies, and gives an evaluation of the procedure. The doctor should also highlight possible side effects and post-complications to the patient.
  2. Patient about to take the medication must not eat before the injection and will have to be driven home after the medication.
  3. Patient will be positioned face down on the operating table and a pillow under the belly to straighten the lumbar lordosis.
  4. A mild sedative or intravenous medication is administered to help the patient relax.
  5. With the help of an X-ray procedure called Fluoroscopy (Tunnel Vision), the needles are injected at the back near the hip bones. This is done carefully to avoid injecting any blood vessels.
  6. Dye is injected to affirm that the medication will go to the right spots.
  7. The anesthetic is injected, followed by the steroid. The steroid is administered to provide long-term relief.
  8. The patient can relax for a while before leaving the hospital. The procedure should not exceed 20 to 30 minutes.

What happens after the procedure?

After the medication, the pain reduces but returns with time. The relief comes as soon as the patient receives the injection i.e. within 15 to 30 minutes. The relief is sustained for few hours to a day but if a steroid medication was included, it could last 2 to 3 days depending on patient’s nervous system.

After a Hypogastric Plexus Block, patient is advised to avoid rigorous duties, exercises or carrying heavy objects. They are not expected to drive for a day or two neither should they operate on any immobile machineries.

Hypogastric Plexus Block can be done every 2-3 months if the patient experiences chronic pains in the pelvic region again.

What are the side effects of Hypogastric Plexus Block?

  • Soreness and bruises at the injection sites
  • Bleeding
  • Slight fever
  • Sleeping disorder
  • Migraine
  • Faster heartbeat
  • Belly cramps

What are the risks and complications of Hypogastric Plexus Block?

  • Neurolysis

    This may be as a result of toxicity due to over-dosage; this may permanently cause nerve failure or damage.

  • Sexual dysfunction

    A superior hypogastric plexus block can cause organ failure. Since sexual organs surround the pelvic region and are controlled by the hypogastric plexus nerves, there are possibilities of sexual dysfunction.

  • Organ injury

    Hypogastric Plexus Block

  • There are also rare chances of puncturing the uterus, kidney or blood vessels. This is not a common risk or complication.

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