Hypogastric Plexus Block

What Is a Hypogastric Plexus Block?

The superior hypogastric plexus is a collection of sympathetic nerve fibers located in the upper front portion of the pelvis. It transmits pain signals from:

1. Pelvic organs
2. Bladder
3. Lower intestines
4. Uterus and ovaries
5. Vagina
6. Prostate and testicles

A hypogastric plexus block involves injecting local anesthetic, with or without corticosteroid medication, near this nerve bundle under imaging guidance.

This procedure is often performed as a series of injections at weekly intervals depending on clinical response.

Conditions Treated

Hypogastric plexus blocks may provide relief for:

• Chronic pelvic pain
• Cancer-related pelvic pain
• Endometriosis
• Pelvic inflammatory disease
• Prostatitis
• Interstitial cystitis
• Dysmenorrhea
• Dyspareunia
• Myofascial pelvic pain syndrome
• Vulvitis
• Cystitis
• Varicocele-related pain
• Sympathetically mediated pelvic pain
• Pelvic congestion syndrome
• Pelvic fibrosis
• Radiation-induced neuropathy
• Irritable bowel syndrome with pelvic pain component

This procedure is particularly effective for pain mediated by the sympathetic nervous system.

How the Procedure Is Performed

Hypogastric plexus blocks are performed in an outpatient setting using fluoroscopic or CT imaging guidance.

1. The patient is positioned appropriately on the procedure table.
2. The skin over the lower back is sterilized.
3. Local anesthetic is administered to numb the skin.
4. Using imaging guidance, a needle is advanced to the region near the superior hypogastric plexus.
5. Contrast dye may be injected to confirm accurate placement.
6. Local anesthetic, with or without corticosteroid medication, is injected.

Many patients experience pain relief within 20 minutes of the local anesthetic injection. If a steroid is included, longer-lasting relief may occur.

Benefits of Hypogastric Plexus Blocks

• Targeted relief of chronic pelvic pain
• Minimally invasive outpatient procedure
• Rapid onset of pain relief
• Reduction in pelvic organ–related pain
• Potential decrease in opioid medication use
• Improved quality of life and function

Frequently Asked Questions