A Comprehensive Update of the Superior Hypogastric Block for the Management of Chronic Pelvic Pain

Urits, Ivan; Schwartz, Ruben; Herman, Jared; Berger, Amnon A; Lee, David; Lee, Christopher; Zamarripa, Alec; Slovek, Annabel; Habib, Kelly; Manchikanti, Laxmaiah; Kaye, Alan D.; Viswanath, Omar

doi:10.1007/s11916-020-00933-0

Cited by 11 publications

(11 citation statements)

References 74 publications

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“…Obviously, the present results suggested that ganglion impar block may not sufficiently interrupt somatic malignant painful stimulation, although it showed more effective response in patients with cancer-related pain than in those with non-cancer-related pain. In addition, because the superior hypogastric plexus also carries visceral nociceptive stimuli from pelvic organs [22], pelvic organ cancer-related pain in non-responsive patients may have been mediated by the superior hypogastric plexus as well as the ganglion impar. This may also explain why some cancer-related pain did not respond to ganglion impar block.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study

Kim¹,

Jang²,

Leem³

et al. 2021

Int. J. Med. Sci.

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Background:The ganglion impar (ganglion of Walther) block has been used to manage coccygeal and perineal (perianal and genital) pain due to both benign and malignant causes. However, the factors associated with successful responses to ganglion impar block are unknown. Therefore, in the present study, we aimed to identify the independent factors associated with successful responses to ganglion impar block in patients with chronic pain in coccygeal and perineal regions. Methods: From January 2008 to December 2017, we performed a retrospective review of 106 patients who underwent ganglion impar block. Patients were considered successful responders if they reported a decrease of more than 50% or 4 points on the 11-point (0 = no pain and 10 = worst possible pain) numerical rating scale 1 month after the procedure, while others were considered non-responders. Logistic regression analysis was performed to identify factors independently associated with successful responses at 1 month after the procedure. Results: Multivariable logistic regression analysis showed that cancer-related causes were significantly associated with successful responses at 1 month after ganglion impar block (odds ratio = 2.60, 95% confidence interval = 1.05 to 6.43, P = 0.038). Conclusion: Ganglion impar block may be more effective in cancer-related pain than pain due to benign causes.

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Section: Discussionmentioning

confidence: 99%

Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study

Kim¹,

Jang²,

Leem³

et al. 2021

Int. J. Med. Sci.

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“…The superior hypogastric plexus block (SHPB) is indicated for pelvic visceral pain and pelvic cancer pain. The classic technique of SHPB described by Plancarte et al in 1990 was a fluoroscopy-guided, posterior, two-needle approach [18][19][20]. This classic technique was found to reduce pain in 70%-90% of patients experiencing pelvic pain secondary to cervical, prostate, and testicular cancer or radiation injury [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…The classic technique of SHPB described by Plancarte et al in 1990 was a fluoroscopy-guided, posterior, two-needle approach [18][19][20]. This classic technique was found to reduce pain in 70%-90% of patients experiencing pelvic pain secondary to cervical, prostate, and testicular cancer or radiation injury [18,19]. Another study found similar outcomes when performing the SHPB using the classic technique on 180 patients with visceral pelvic pain associated with malignancy (55% being cervical cancer and 11% with ovarian cancer), with a 55.5% pain reduction found at 33 months [18].…”

Section: Discussionmentioning

confidence: 99%

“…This classic technique was found to reduce pain in 70%-90% of patients experiencing pelvic pain secondary to cervical, prostate, and testicular cancer or radiation injury [ 18 , 19 ]. Another study found similar outcomes when performing the SHPB using the classic technique on 180 patients with visceral pelvic pain associated with malignancy (55% being cervical cancer and 11% with ovarian cancer), with a 55.5% pain reduction found at 33 months [ 18 ]. Another study utilizing the classic technique found pain reduction in 72% of patients suffering from gynecologic, colorectal, or genitourinary cancer (including 142 females with gynecological cancer and 17 males with prostate, colorectal, or bladder carcinomas) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another study utilizing the classic technique found pain reduction in 72% of patients suffering from gynecologic, colorectal, or genitourinary cancer (including 142 females with gynecological cancer and 17 males with prostate, colorectal, or bladder carcinomas) [ 21 ]. Other techniques for SHPB include transdiscal, posteromedian, posterior paravertebral, and CT-guided anterior and posterior approaches [ 5 , 8 , 18 , 20 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Fluoroscopic-Guided Bilateral Superior Hypogastric Plexus Neurolysis in the Treatment of Intractable Neoplasm-Related Penile Pain

Fisher¹,

Daoud²,

Gonzalez³

et al. 2021

Cureus

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Intractable penile pain can be a very difficult condition to address. Studies have shown that both locally advanced and metastatic penile cancer, along with its associated management options and subsequent complications, yield a very poor prognosis, with pain being the most feared symptom. Furthermore, a lack of palliative therapy has been demonstrated in this patient population, with an emphasis on the need for implementing future options. This case depicts a 67-year-old male, with a past medical history of metastatic prostate cancer involving the penis, who presented with intractable penile pain. To the authors' knowledge, this will be the first documented case of the successful utilization of a bilateral superior hypogastric plexus neurolysis in the management of intractable neoplasm-related penile pain attributed to both radiationinduced injury in the treatment of malignant neoplasm and penile pain secondary to metastatic prostate cancer to the penis. As a currently under-utilized treatment option in the management of intractable neoplasm-related penile pain, this case presentation acts to increase awareness of its potential use, therefore reducing the need for analgesics and the associated burdens, as well as improving patient palliation. Furthermore, this case offers evidence supporting the encouragement of its use in the general management of intractable penile pain due to other pathophysiology.

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Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department

Stenberg,

Septaric,

Simon

2024

The American Journal of Emergency Medicine

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A Comprehensive Update of the Superior Hypogastric Block for the Management of Chronic Pelvic Pain

Cited by 11 publications

References 74 publications

Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study

Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study

Fluoroscopic-Guided Bilateral Superior Hypogastric Plexus Neurolysis in the Treatment of Intractable Neoplasm-Related Penile Pain

Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department

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