Hypogastric Plexus Block

A hypogastric plexus block is a specialised interventional pain procedure targeting the network of nerves (hypogastric plexus) that carry pain signals from the pelvic region to the brain. This minimally invasive treatment offers relief for individuals suffering from chronic pelvic and lower abdominal pain conditions that haven't responded adequately to conventional treatments.

How It Works

The hypogastric plexus block involves precisely injecting local anaesthetic and sometimes anti-inflammatory medications around the nerve bundle located in front of the spine at the L5-S1 level. This temporary interruption of pain signals can provide significant relief and improved function for many patients with chronic pelvic pain conditions.

Mechanism of Action

The procedure achieves pain relief through several mechanisms:

• Disruption of pain signal transmission
• Reduction of nerve inflammation
• Decrease in sympathetic nerve activity
• Potential long-term modulation of pain pathways

Scientific Evidence

Research supports the effectiveness of hypogastric plexus blocks for chronic pelvic pain:

Several clinical studies have demonstrated 50-80% pain reduction in patients with chronic pelvic pain conditions
Long-term follow-up studies show sustained benefits lasting 3-6 months after treatment
Systematic reviews indicate particularly good outcomes for cancer-related pelvic pain and endometriosis

Treatment Process

The procedure is performed under imaging guidance (fluoroscopy or CT) to ensure precise placement:

• Initial consultation and medical evaluation
• Detailed imaging to plan approach
• Local anaesthetic administration
• Precise needle placement using real-time imaging
• Injection of therapeutic medications
• Brief recovery period

Most patients can return home the same day and resume normal activities within 24-48 hours.

Safety and Considerations

While generally safe, potential side effects may include:

• Temporary numbness or weakness in the lower extremities
• Mild bruising at injection site
• Short-term increase in pain before improvement
• Rare risks of infection or bleeding

Integration with Other Treatments

Hypogastric plexus blocks often work best as part of a comprehensive pain management strategy:

• Physical therapy
• Medication management
• Lifestyle modifications
• Stress reduction techniques
• Regular exercise programmes

Success rates are highest when combined with appropriate complementary treatments and lifestyle changes.