Procedure Description
A hypogastric plexus nerve block is a minimally invasive procedure used to diagnose and treat chronic pelvic pain by targeting the superior hypogastric plexus—a bundle of nerves located in front of the lower spine near the L5–S1 vertebral level. These nerves transmit pain signals from various pelvic structures, including the bladder, uterus, prostate, rectum, and lower intestines.
By injecting a local anesthetic and sometimes a steroid near the hypogastric plexus, the procedure disrupts pain transmission, providing significant relief for patients suffering from cancer-related or non-cancer pelvic pain.
What It Treats
A hypogastric plexus block is used to treat:
Chronic pelvic pain (male and female)
Bladder or rectal pain syndromes
Gynecologic pain (e.g., endometriosis, pelvic congestion syndrome)
Prostate or testicular pain
Pain related to pelvic cancer (e.g., uterine, cervical, rectal, or prostate cancer)
Post-surgical pelvic pain
This procedure is effective when pain is visceral (deep and aching) and not relieved by other treatments like medications or physical therapy.
How It Is Performed
You will lie on your stomach on a procedure table.
The lower back area is cleansed and numbed with a local anesthetic.
Using fluoroscopy (X-ray) or CT guidance, your physician inserts one or two thin needles through the back to reach the area just in front of the L5–S1 vertebral bodies, where the hypogastric plexus lies.
A contrast dye is injected to confirm accurate needle placement.
A combination of local anesthetic and steroid is then injected. In cancer cases, a neurolytic agent (e.g., alcohol or phenol) may be used to destroy the nerve fibers for longer-lasting relief.
The needles are removed and a bandage is applied.
The procedure typically takes 20–30 minutes and is performed on an outpatient basis.
Pre-Procedure Instructions
Do not eat or drink for 6 hours before the procedure if sedation is planned.
Continue most regular medications unless advised otherwise. You may be asked to pause blood thinners several days in advance—follow your provider’s instructions.
Inform your provider if you:
Are pregnant or breastfeeding
Have allergies to contrast dye, local anesthetics, or steroids
Have a bleeding disorder or active infection
Arrange for transportation if sedation is used or if discomfort limits your mobility afterward.
What to Expect After the Procedure
Pain relief may begin within hours to a few days following the procedure.
Some patients experience temporary numbness, weakness, or soreness in the lower back or pelvis.
If a diagnostic block is successful, longer-lasting relief can be achieved with repeated blocks or neurolytic ablation.
Avoid strenuous activity for 24–48 hours and follow your physician’s specific post-procedure instructions.
Call your provider immediately if you experience:
Fever, chills, or signs of infection
New bowel or bladder dysfunction
Persistent or worsening back pain, numbness, or leg weakness
Targeted Relief for Deep Pelvic Pain
At Parkview Spine & Pain, our team offers hypogastric plexus nerve blocks using precise, image-guided techniques to address complex pelvic and cancer-related pain. Whether your symptoms are due to chronic inflammation, surgery, or cancer, this advanced treatment may help restore your comfort and quality of life.
👉 Schedule your consultation today to see if a hypogastric plexus block is right for you.