Superior Hypogastric Plexus Block
What is a celiac plexus nerve block?
A superior hypogastric plexus block (SHPB) is a type of injection. It’s used to diagnose and treat pain in the lower part of the abdomen and the pelvis.
Your brain sends information to the body through pathways known as nerves. Nerves also receive information from the body and send it to the proper regions of the brain. A nerve plexus is a place in the body where many different nerves intersect. Nerves that communicate some types of pain signals from the lower abdomen and pelvis pass through the superior hypogastric plexus on their way to the brain.
Your superior hypogastric plexus sits in front of the spine in the lower part of your back. Nerves from several parts of the lower abdomen and pelvis pass through this plexus. That includes nerves from the following organs:
- Bladder or urethra
- Lower intestines
- Uterus, ovaries, or vagina
- Prostate, testicles, or penis
During an SHPB, a healthcare provider will place needles in your back on both sides of the spine. He or she will move them to a position in front of the spine where the superior hypogastric plexus is located. Then he or she will inject medicine into the area to ease pain.
what conditions can ankle injections help with?
You might need an SHPB if you have pain in the lower abdomen or pelvis that stems from dysfunction or damage in the pelvic organs. Another name for pain from your organs is visceral pain. This type of pain is often constant and deep. It spreads out through the lower abdomen and pelvis rather than just in one particular spot.
For example, an SHPB might help your pain if you have:
- Ovarian, cervical, endometrial, or uterine cancer
- Prostate or colon cancer
- Bladder cancer
- Injury to the pelvis from surgery or radiation treatment
- Chronic low abdominal or pelvic pain
Your healthcare provider may use SHPB to diagnose the cause of your pain. He or she can do so by injecting numbing medicine (local anesthetic) in the area to see if your pain improves. The shot helps to pinpoint the pelvic organs as the source of pain. In other cases, SHPB can be used to treat your pain with injection of other medicine in the area.
how does it work?
Your exact procedure may differ. But general steps for an SHPB might include the following:
- You will lie on your stomach on a procedure table.
- You may get medicine to help you relax (sedation).
- During the procedure, your heart rate, blood pressure, and oxygen level will be watched. You may get extra oxygen by a mask or nasal tubing.
- The area of your lower back where you will have the injection will be cleaned.
- The healthcare provider will use medicine to numb the injection area. It may burn and sting a little. But it should last only a few seconds.
- The provider inserts two needles into your lower back, near each hip bone. He or she will move them to the correct position. He or she may use live X-rays, CT imaging, or ultrasound to help guide the needles.
- The provider injects a small amount of X-ray contrast dye through these needles to make sure they are in exactly the right spot.
- The provider injects medicine through the needles. He or she may use different types of medicines for different reasons. Numbing medicine may be needed to block pain signals. Steroid medicine may be needed to reduce inflammation. Sometimes the provider will use other medicines to temporarily damage the nerves. It stops them from transmitting pain. After the shot, you may feel a warm or burning sensation in the area.
What are the risks of a superior hypogastric plexus block?
SHPB is generally safe. Some possible risks of the procedure are:
- Temporary drop in blood pressure
- Damage to nearby nerves
- Damage to the spinal cord
- Damage to nearby organs
- Damage to nearby blood vessels
- Allergic reaction to the medicines
If you get steroid medicine in your injection, you may have side effects. These include temporary increases in blood sugar levels for 1 to 2 days, an allergic reaction, and flushing of your face. There is also a risk that the procedure will not ease your pain.
You may not be able to have the procedure if you have a high risk of bleeding or if you have an infection in the region of the injection. Your own risk may vary based on your age and other health problems. Before your procedure, talk with your healthcare provider about all your concerns.