Superior Hypogastric Plexus Block
The superior hypogastric plexus innervates the lower sigmoid colon, bladder, ureters, testes, and ovaries. Therefore, by blocking the superior hypogastric plexus, you can interrupt the pain fibers from these pelvic organs. The superior hypogastric plexus is actually a series of ganglia just in front of the fifth lumbar and first sacral vertebra. A diagnostic block is done first with local anesthetic only. If the patient has a good response, we then consider proceeding with a neurolytic block. This is most commonly done for patients with pelvic cancer with lower abdominal/pelvic pain who are already incontinent, as one of the significant side effects or complications with this procedure can be bladder incontinence.