Purpose: To evaluate the use of superior hypogastric plexus block with computed tomographic (CT) guidance in patients with endometriosis and chronic pelvic pain.
Materials And Methods: Seven blocks were performed on an outpatient basis in five women with endometriosis and pelvic pain. In the first four patients, one or two 20-gauge, 15-cm needles were placed anterior to the spine at the common iliac bifurcation from a posterior approach. In the fifth patient, the block was performed from an anterior approach with a single needle.
Results: One procedure resulted in mild pain relief, three in considerable pain relief, one in complete midline pain relief with no change in the lateral pain, and one in complete pain relief. One procedure was terminated because anesthetic was injected into the peritoneal cavity. There were no other complications.
Conclusion: CT-guided superior hypogastric plexus block is easily performed and can be used to assess whether chronic pelvic pain can be attenuated by blocking the superior hypogastric plexus.
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http://dx.doi.org/10.1148/radiology.196.1.7784552 | DOI Listing |
CVIR Endovasc
January 2025
Department of Medical Imaging, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Background: Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines.
View Article and Find Full Text PDFAgri
January 2025
Division of Algology, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye.
The superior hypogastric plexus (SHP) contains afferent nociceptive fibers from the pelvic structures, thus the SHP block is employed in the chronic pelvic pain (CPP) treatment in patients who do not respond to conservative treatments. A 60-year-old female patient, who did not respond to conservative treatment, underwent SHP neurolytic block after a successful diagnostic block. An excessive oblique angle approach was applied due to physical restrictions, the needle passed through the intervertebral disc resulting in the contralateral side SHP block, and the procedure was also repeated to the other side SHP.
View Article and Find Full Text PDFAm J Gastroenterol
November 2024
Division of Neurogastroenterology/Motility, Medical College of Georgia, Augusta University, Augusta, Georgia.
Anorectal neuropathy causes anorectal dysfunction, yet it is poorly recognized. This stems from both a lack of understanding of the extrinsic and intrinsic innervation of the anorectum and tools for evaluation of neuronal function. Our objective was to provide an improved understanding of the neuronal networks of the anorectum and discuss its functional significance.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Oblique lumbar interbody fusion (OLIF) is a minimally invasive lateral lumbar fusion technique and patients are discharged 1-2 days after surgery. Because OLIF utilizes a retroperitoneal approach close to the superior hypogastric plexus, postoperative urinary retention (POUR) may not be an uncommon problem. The purpose of this study was to present the incidence and outcomes of POUR with a systematic care protocol.
View Article and Find Full Text PDFTech Vasc Interv Radiol
September 2024
Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA. Electronic address:
Chronic abdominal visceral pain management often requires multidisciplinary collaboration. Image-guided visceral nerve interventions may be critical in the management of visceral pain refractory to medical treatments. Abdominal and pelvic pain is mediated by specific nerves involving specific ganglia.
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