What Is a Hypogastric Plexus Block?

Medically Reviewed by Tyler Wheeler, MD on February 25, 2024
3 min read

A hypogastric plexus block is a treatment consisting of a series of several injections.  It is used for pain relief. It is typically given to people who have pain that comes from their pelvic structures, including the uterus, ovaries, vagina, prostate, and testicles. This treatment works by blocking pain receptors from carrying messages to your brain.

The hypogastric plexus is made up of various nerves positioned at your fifth lumbar and first sacral vertebrae in your spine. It is found on the lower part of your abdomen in front of the pelvis. 

The hypogastric plexus is where the nerves for many of the internal organs of the pelvis are located. Usually, people who have pain in these organs take medications for pain relief. Hypogastric plexus block injections are used when these options do not work.

Side effects from nerve blocks for pelvic pain are rare. However, there can be:

  • Allergic reaction to the medication
  • Nerve damage
  • Bleeding and bruising where you are injected
  • Infection 
  • Inflammation in your spinal discs
  • No difference in your pain

You will need to make preparations for someone to drop you off at the procedure and pick you up afterward. You will also not be allowed to eat or drink for the six hours before your procedure. Water or other clear liquids are an exception. You may be permitted to drink them up to two hours before your pelvic pain injections.

It is also possible that you will need to stop taking certain medicines days before the procedure so that they don’t interact with the pain block. Give your provider the complete list of prescription medications you take. You should also let your doctor know of herbal or over-the-counter medicines you are taking.

Let your doctor know if you have any allergies or asthma. Also let them know if you have ever had any sort of allergic reaction to the dye used in any other type of radiology exam. These reactions typically include:

  • Hives
  • Itchiness
  • Trouble breathing

Before your procedure, you will get an IV line. This will give you fluids and sedate you. You might also get an antibiotic through your IV. The procedure will then go as follows:

  • You will be put on monitoring equipment. This equipment can include an EKG monitor, a blood pressure cuff, or a blood oxygen monitor. Typically, these go on your stomach. 
  • Your back will be cleaned with antiseptic. Next, your doctor will inject you with a numbing medicine. This typically will give you a burning sensation for a couple of minutes. 
  • The needle is injected. Your doctor will find the exact location of your hypogastric plexus with an X-ray. They will use a contrast dye to help this process. Finally, your doctor will give you a more localized anesthetic as well. 
  • Alcohol injection. Sometimes you will get alcohol injected into the hypogastric plexus to destroy the nerves completely.

After you have this procedure done, you may need about 30 minutes to recover. Sometimes you will start to experience more back pain, especially if your doctor injected alcohol into your back. Usually, you just feel this as the anesthesia wears off, but it can continue several days after your procedure. 

Usually, this procedure takes a total of 30 minutes, and you can go home immediately afterwards. Your pelvis might feel warm. Many patients say that within 30 minutes after the procedure they don’t feel any other pain. However, the norm is that the longer-term pain relief begins to work within two to three days of the procedure.

Usually, the pain relief lasts for weeks. However, this greatly varies from person to person. If your pain returns, you should let your doctor know. You can always discuss getting another hypogastric plexus block.

After the procedure, you can immediately eat your regular foods and take your normal medications. Don’t drive or do any sort of rigorous activity for up to 24 hours afterward. You will be able to resume your normal routine again the next day.