The hypogastric block is two separate groups of nerves, the superior and inferior hypogastric nerves.
These nerves join together to form ganglia or clusters of cell bodies that reside in front of the vertebral bodies of the uppermost lumbar spine.
A hypogastric block is indicated for painful conditions of the pelvis.
These include rectal, uterus, and ovary cancer, endometriosis, and pelvic pain with unknown etiology.
Preparing for a hypogastric block:
After obtaining consent, you will be positioned face down on a fluoroscopic carbon fiber table.
Fluoroscopic images will be taken to identify the best trajectory for needle placement.
Often a mild sedative is administered to make you more comfortable and reduce anxiety.
A very thin needle is used to target the location of the hypogastric nerve plexus and once the needle tip is in position an X-Ray Inc. with contrast is injected to identify correct placement.
When recorded imagines are found to be satisfactory a long-acting local anesthetic often with a small amount of steroid is injected.
Monitoring is continued for several minutes after the medication is injected.
The needle is withdrawn and pressure is applied over the area along with some ice packs the area is cleaned and a Band-Aid is applied.
Post-procedure, you may feel a little different in the areas of your pain.
Pain reduction can be immediate and this will be recorded by your physician.
Over time the pain relief may be lasting or a repeat injection may be necessary in some cases, if the pain relief is satisfactory immediately after the procedure but the pain returns then a radiofrequency ablation or other nerve destruction of the hypogastric plexus may be considered.
Often this is done in consultation with your primary care doctor and oncologist.