Superior Hypogastric Block

What is a Superior Hypogastric Block?
The Superior Hypogastric Block is an injection of local anesthetic in the "hypogastric nerves", which can be thought of as a continuation of the lumbar sympathetic nerve chain. The nerves are located on both sides of the spine, in the back and continue down to pass on each side of the rectum and along each side of the bladder.

What is the purpose of this procedure?
This injection is useful in the evaluation and treatment of pelvic and perineal pain.

How long does the injection take?
The actual injection usually takes about 30 minutes.

What is actually injected?
The injection consists of a local anesthetic (like Lidocaine or Bupivacaine).

Will the injection hurt?
The procedure involves inserting a needle in the back through skin and deeper tissues. So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the actual block needle.

Will I be "put out" for this procedure?
No. This procedure is done under local anesthesia.

How is the injection performed?
An I.V. catheter will be inserted prior to the procedure.
You will be asked to lie down on an xray table on your stomach for this block. The skin on the low back will be cleansed with a sterile solution called Betadine. Next, the physician injects a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle, using x-ray guidance to the area of the hypogastric plexus nerves. A small amount of contrast (dye) is injected to insure proper needle position. Then, a small mixture of numbing medicine (local anesthetic) is injected.

What happens after the procedure?
Immediately after the procedure, you will be moved to the recovery area where you are monitored for at least 45 minutes. The recovery room nurse checks you periodically. You will be asked to urinate prior to being dismissed. You will be asked to report the percentage of pain relief and report the relief experienced during the next week by calling the clinic.

What are the risks and side effects?
This procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain - which is temporary. The other risk involves bleeding, infection, spinal block, epidural block, and injection into blood vessels and surrounding organs. Fortunately, the serious side effects and complications are uncommon.

Who should not have this injection?
If you are allergic to any of the medications to be injected, if you are on blood thinning medications (e.g. Coumadin®, Plavix®, Ticlid®), or if you have an active infection going on near the injection site, you should not have the injection

General Pre/Post Instructions
Patients may eat a light meal before the procedure. If a patient is an insulin dependent diabetic, they should take their insulin and eat.

Patients may take their routine medications. (i.e. high blood pressure and oral diabetic medications). If a patient is on Coumadin, Lovenox, or Plavix (blood thinners) they must notify the office so that special instructions may be given.

If you are allergic to iodine, contrast, or medical dye, please inform the office. Patients can expect to be at that facility approximately 1½.

A driver must accompany the patient and be responsible for getting them home. It is best if no driving is done the day of the procedure and after the injection. Patients may return to their normal activities the day after the procedure, including returning to work unless otherwise instructed by the physician.