A superior hypogastric plexus block is a targeted, image-guided injection that interrupts pain signals traveling from the pelvic organs, helping to relieve chronic pelvic pain when medications and other treatments have not given enough relief.
OVERVIEW
What a hypogastric plexus block is and how it works
The superior hypogastric plexus is a bundle of sympathetic nerves that lies deep in the lower abdomen, in front of the spine near where the lumbar and sacral vertebrae meet (the L5–S1 level). These nerves carry pain sensation from many of the organs in the lower pelvis. When pelvic pain becomes chronic and hard to control, blocking this plexus can quiet those signals before they travel up to the brain.
During the procedure, your physician uses a thin needle guided by live X-ray (fluoroscopy) to reach the plexus and deposit medication. A local anesthetic is used to confirm the correct target and, in a diagnostic block, to see whether your pain improves. When the goal is longer-lasting relief, a steroid or, in cancer-related pelvic pain, a neurolytic (nerve-deadening) agent may be added. The block is often used in two ways: as a diagnostic tool to confirm that these nerves are the source of your pain, and as a therapeutic treatment to reduce it.
CONDITIONS
Pelvic pain conditions this block may help
A superior hypogastric plexus block is most often used for chronic pelvic pain that has not responded well to medications or other therapies, including gynecologic pain and pain related to pelvic cancer. Your physician will help determine whether your symptoms point to these sympathetic nerves.
Commonly treats
YOUR VISIT
What to expect
Before
Your physician reviews your history, prior imaging, and medications. Let us know about blood thinners, diabetes medications, or any active infection, as these may need to be managed beforehand. You may be asked to arrange a ride home. The procedure is performed on-site at our Burnside Surgery Center in Gresham.
During
You lie face down while the skin over your lower back is cleaned and numbed. Using fluoroscopic (X-ray) guidance with contrast dye for accuracy, your physician advances the needle to the plexus and injects the medication. The injection itself takes only a few minutes; most visits are completed in about 30 to 45 minutes.
After
You will rest in a recovery area for a short time while we monitor you. Some people notice pain relief within hours, though steroid or neurolytic effects may take several days to develop. Mild soreness at the injection site is common and usually settles quickly. Many patients resume normal activity the next day. We will review your response at follow-up and discuss whether repeat or longer-lasting treatment is appropriate.
QUESTIONS
Frequently asked questions
Is a hypogastric plexus block the same as a celiac plexus block?
No. Both target sympathetic nerves, but in different regions. The celiac plexus block addresses upper abdominal pain, while the hypogastric plexus block targets the lower pelvis. Your physician recommends the block that matches the location of your pain.
How long does the relief last?
This varies widely. A diagnostic block with local anesthetic may last only hours, while a therapeutic steroid or neurolytic block can provide weeks to months of relief for some patients. Because responses differ, we use your results to guide next steps rather than promise a specific outcome.
Is the procedure painful?
The skin is numbed first, so most patients feel pressure rather than sharp pain during the block. Brief discomfort is normal, and our team works to keep you comfortable throughout.
LEARN MORE
Related procedures and next steps
The superior hypogastric plexus block is one of several plexus and ganglion blocks we offer in the Gresham and greater Portland area. Explore related options below or view our full list of services.
Celiac Plexus Block
Targets chronic upper abdominal pain, including pancreatic and abdominal cancer pain. Learn more
Pudendal Nerve Block
Addresses pelvic and perineal pain involving the pudendal nerve. Learn more
Sympathetic Nerve Block
A broader category of blocks targeting the sympathetic nervous system. Learn more