What is a hypogastric plexus block?
The hypogastric plexus is a collection of nerves that is located in front of the fifth lumbar and first sacral vertebral bodies. This means that the plexus is located near the lower part of your abdomen in the upper front of your pelvis. A hypogastric plexus block involves the administration of a dose of pain killing medication near the region of this nerve collection. The hypogastric block usually involves a series of several injections, repeated at weekly intervals. This treatment has brought relief to many patients who suffer from pain located in the pelvic structures, to include pain located in the region of the bladder, lower intestines, as well as the uterus, ovaries and in women, and the prostate and testicles in men.
How quickly can I expect pain relief?
Most patients can expect pain relief within the first 15 to 20 minutes after the injection of local anesthetic. This pain relief may only last several hours; however, if the physician has also used steroid medication, you may also receive some pain relief that will begin roughly 36 hours after the injection. Duration of pain relief is somewhat variable, as it differs from patient to patient.
How should I prepare for the procedure?
The hypogastric plexus block is a safe medical procedure; but, as with any procedure, it has risks as well as benefits. To minimize the chance of complications, we ask that you follow a few simple guidelines:
Do not eat or drink anything for (8) eight hours prior to the procedure.
It is required that you be accompanied to and from Ambulatory Surgery Centerby a responsible adult driver. Most likely you will be offered a small dose of intravenous medication during the procedure which will act to not only decrease anxiety, but provide you some pain relief from the minor discomfort of the procedure itself. This intravenous medication that you receive will impair your driving ability; therefore, it is imperative that you be accompanied by a responsible adult driver.
Plan on spending roughly one to two hours at the Ambulatory Surgery Center. This allows for time for registration, preparation, performance of the procedure and observation after the procedure.
What happens during the procedure?
First, an intravenous line will be placed, generally in your hand. We will then bring you to the operating room and place several monitors on you, such as a heart, blood pressure and a pulse. These will enable us to monitor your vital signs throughout the procedure. Following placement of the monitors we will begin to give you some intravenous medication in order to decrease anxiety, as well as provide you with some pain relief.
You will then be placed in the prone position (on your stomach). The physicians will then use x-ray guidance to aid in appropriate placement of the medication. After clearing a small patch of your skin, a local anesthetic is injected into the skin to decrease any pain associated with performance of the procedure. The medication will then be administered through a needle near your hip bones on both sides. The procedure itself usually lasts 10 to 15 minutes. Occasionally, patients describe a very transient recurrence of their pelvic pain during administration of their medication. This is viewed as a reassuring sign that the medication is going to the right place, and the sensation usually disappears very quickly.