The hypogastric plexus is a collection of nerves that is located in front of the fifth Lumber 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 vagina in women, and the prostate and testicles in men.
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.
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.
After the hypogastric plexus block is performed, we will continue to monitor you in the recovery room for 30 to 40 minutes. If there are no signs of any problems, you will be ready to leave.
Expect the block to provide you with several hours of pain relief and after this time, the pain will likely return. If the physicians have used steroid medication in addition to the local anesthetic, this may provide you with further pain relief after 36 to 48 hours. Sometimes, this block is performed for diagnostic reasons. This means that your physicians have chosen to do this block in order to determine a possible cause for your pain. In this instance, you may or may not experience any pain relief.
The most common side effect from this procedure is a sore back in the region where the blocks were performed. There is a very small chance of the needle puncturing a blood vessel. This potentially could lead to blood clot formation in your pelvis; however, this is extremely rare and your physician will take extra precautions to attempt to avoid this complication. There is also a very rare chance of injury to either the kidney or urethras. The urethras are the structure that connects your kidneys to your bladder. These risks are, again, extremely small and are even less likely when the procedure is performed under x-ray guidance.
You may NOT drive for the remainder of the day after your procedure. No heat is to be used on the injection area for the remainder of the day. No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.
If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.
If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.
ON THE DAY OF YOUR PROCEDURE, PLEASE DO THE FOLLOWING:
♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.
♦ Have a responsible person to take you home.
♦ Arrive at the requested procedure time. Please do not be late or your procedure may be cancelled.
ON THE DAY OF YOUR PROCEDURE:
♦ Do not take ANY of the following 5 days before your procedure: Coumadin
♦ Do not take ANY of the following 7 days before your procedure: Plavix
♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection. Do not stop the drug by yourself.
♦ Eat or drink 6 hours before the procedure.
NOTE: YOUR PROCEDURE WILL BE CANCELLED IF:
- You have an active infection, flu, cold, fever, or very high blood pressure.
- You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.
Call the office at (513) 860-1039 for procedure related questions.