Hypogastric Plexus Block
A superior hypogastric plexus block targets the autonomic nerve network that transmits pain signals from the pelvic organs — including the bladder, uterus, ovaries, prostate, descending colon, and rectum — to the spinal cord. By interrupting these pain pathways, hypogastric plexus blocks can provide significant relief for chronic pelvic pain from a variety of causes.
Conditions Treated
- Pelvic cancer pain — Including cervical, uterine, ovarian, prostate, and rectal cancer. One of the most important indications; can dramatically reduce opioid requirements in cancer patients.
- Endometriosis — Chronic pelvic pain from endometrial implants responding to visceral nerve blockade
- Interstitial cystitis — Bladder pain syndrome with sympathetic/visceral component
- Chronic pelvic inflammatory conditions
- Radiation proctitis — Pelvic pain after radiation therapy
How the Block Works
The superior hypogastric plexus is located anterior to the L5-S1 disc and the upper sacrum. Under fluoroscopic guidance, Dr. Rubin places bilateral needles (or a single posterior midline approach) adjacent to this nerve complex. Local anesthetic (and sometimes neurolytic solution for cancer pain) is injected to block pain signal transmission from the pelvic organs.
A neurolytic (permanent) block using phenol or absolute alcohol is sometimes recommended for cancer pain — providing longer-lasting relief that reduces the need for escalating opioid doses.
Results
For cancer-related pelvic pain, hypogastric plexus neurolysis can reduce pain scores by 50–70% and significantly decrease opioid requirements — improving quality of life and reducing medication side effects.
For benign pelvic pain conditions, diagnostic blocks with local anesthetic help identify whether the sympathetic component is a significant contributor, guiding further treatment planning.
Contact Us
For chronic pelvic pain — especially cancer-related pelvic pain — call 516-492-3100 to discuss whether a hypogastric plexus block is an appropriate option.