scholarly journals Inferior Hypogastric Block for the Treatment of Chronic Pelvic Pain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ivan Urits ◽  
Ruben Schwartz ◽  
Harish Bangalore Siddaiah ◽  
Sathyadev Kikkeri ◽  
David Chernobylsky ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Treatment Options ◽  
Multiple Systems ◽  
Complex Disorder ◽  
Hypogastric Plexus ◽  
Promising Treatment ◽  
Pharmacologic Treatments ◽  
Plexus Block ◽  
Optimal Patient Management

Context: Pelvic pain is described as pain originating from the visceral or somatic system localizing to the pelvis, the anterior abdominal wall at the level of or below the umbilicus, lumbosacral back in either men or women. Evidence Acquisition: Narrative review. Results: Chronic pelvic pain can be a complex disorder that may involve multiple systems such as urogynecological, gastrointestinal, neuromusculoskeletal, and psychosocial systems. The etiopathogenesis for chronic pain remains unknown for many patients. For achieving optimal patient management, a multimodal and individualized assessment of each patient is the best strategy. Conclusions: There are non-pharmacologic treatments as well as pharmacologic treatments. In addition to these treatment options, inferior hypogastric plexus block is a promising treatment modality.

Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer

Pain ◽  
1993 ◽  
Vol 54 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Oscar A. de Leon-Casasola ◽  
Edward Kent ◽  
Mark J. Lema
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Hypogastric Plexus ◽  
Superior Hypogastric Plexus ◽  
Plexus Block

scholarly journals Superior Hypogastric Plexus Block for Chronic Pelvic Pain Through an S1 Transforaminal Approach: A Case Report

2019 ◽  
pp. 133-137
Author(s):  
Zahra Sykes
Keyword(s):  
Case Report ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Pelvic Surgery ◽  
Pelvic Pain Syndrome ◽  
Transforaminal Approach ◽  
Hypogastric Plexus ◽  
Superior Hypogastric Plexus ◽  
Plexus Block

Chronic prostatitis/chronic pelvic pain syndrome (CPPS) is a debilitating syndrome commonly seen in men under the age of 50 years, which greatly impacts the quality of life. The treatment is challenging, which often requires a multimodal management approach. The superior hypogastric plexus is located anterior to L5 and S1 vertebral bodies in the retroperitoneal space and contains afferent pain fibers from most of the pelvic structures. Performing a superior hypogastric plexus block (SHPB) can potentially alleviate pain originating from various pelvic regions and structures. It is currently a viable therapy for many syndromes including endometriosis, interstitial cystitis, irritable bowel syndrome, and pain after pelvic surgery. In this case report, we present a patient who had chronic pelvic pain with a poor response to conservative management. Initially, attempts at an SHPB from the classic posterolateral approach were unsuccessful. This technique for performing this block can prove difficult due to vasculature variability or anatomic barriers, such as the iliac crest and transverse process of the fifth lumbar vertebrae. Thus, a left S1 transforaminal approach was used to block the plexus. This provided the patient with one month of near 100% pain relief, with gradual return to baseline thereafter. CPPS poses unique treatment challenges. Although often treated conservatively, SHPB is a valid treatment option for those who fail to respond adequately to other modalities. An S1 transforaminal approach is a novel and valuable alternative technique for SHPB in patients with compromising anatomy. Key words: Chronic prostatitis, chronic pelvic pain, superior hypogastric plexus, superior hypogastric plexus block, pelvic trauma, pelvic pain in men

scholarly journals Clinical Management of Chronic Pelvic Pain in Endometriosis Unresponsive to Conventional Therapy

2022 ◽  
Vol 12 (1) ◽  
pp. 101
Author(s):  
Augusto Pereira ◽  
Manuel Herrero-Trujillano ◽  
Gema Vaquero ◽  
Lucia Fuentes ◽  
Sofia Gonzalez ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Conventional Therapy ◽  
Chronic Pelvic Pain ◽  
Myofascial Pain ◽  
Visceral Pain ◽  
University Hospital ◽  
Common Symptom ◽  
Rectal Pain ◽  
Inferior Hypogastric Plexus ◽  
Hypogastric Plexus

Background: Although several treatments are currently available for chronic pelvic pain, 30–60% of patients do not respond to them. Therefore, these therapeutic options require a better understanding of the mechanisms underlying endometriosis-induced pain. This study focuses on pain management after failure of conventional therapy. Methods: We reviewed clinical data from 46 patients with endometriosis and chronic pelvic pain unresponsive to conventional therapies at Puerta de Hierro University Hospital Madrid, Spain from 2018 to 2021. Demographic data, clinical and exploratory findings, treatment received, and outcomes were collected. Results: Median age was 41.5 years, and median pain intensity was VAS: 7.8/10. Nociceptive pain and neuropathic pain were identified in 98% and 70% of patients, respectively. The most common symptom was abdominal pain (78.2%) followed by pain with sexual intercourse (65.2%), rectal pain (52.1%), and urologic pain (36.9%). A total of 43% of patients responded to treatment with neuromodulators. Combined therapies for myofascial pain syndrome, as well as treatment of visceral pain with inferior or superior hypogastric plexus blocks, proved to be very beneficial. S3 pulsed radiofrequency (PRF) plus inferior hypogastric plexus block or botulinum toxin enabled us to prolong response time by more than 3.5 months. Conclusion: Treatment of the unresponsive patient should be interdisciplinary. Depending on the history and exploratory findings, therapy should preferably be combined with neuromodulators, myofascial pain therapies, and S3 PRF plus inferior hypogastric plexus blockade.

Sign in / Sign up

Export Citation Format

Share Document