Hypogastric Plexus Block

Pain Management Treatments in Texas

A hypogastric plexus block (HPB) is a procedure in which a local anesthetic and/or steroid is injected into the hypogastric plexus, a bundle of nerves located in the lower abdomen in front of the pelvis. The hypogastric plexus is responsible for carrying pain signals from the pelvic organs to the brain. By blocking the hypogastric plexus, pain relief can be achieved for a variety of conditions.

When is a hypogastric plexus block needed?

We often use an HPB with individuals who are experiencing chronic pelvic pain that has not responded to or improved with other standard or conventional treatments. This may include pain from:

  • Endometriosis
  • Chronic prostatitis
  • Bladder pain syndrome/interstitial cystitis
  • Pelvic inflammatory disease
  • Cancer of the pelvic organs
  • Complex regional pain syndrome (CRPS)
  • Post-herpetic neuralgia

HPB may also be used as a diagnostic tool to determine if the hypogastric plexus is the source of a patient's pain.

How is a hypogastric plexus block performed?

HPB is typically performed using fluoroscopic guidance, a medical imaging technique that uses a type of X-ray technology called fluoroscopy, which allows the physician to visualize the needle placement in real time. The patient is positioned on their stomach on the fluoroscopy table. The physician then cleans and sterilizes the skin at the injection site. A local anesthetic is injected to numb the area.

Using a fluoroscopic needle guide, the physician then inserts one or more needles into the lower back, near the hip bone. Dye may be injected to confirm that the needles are in the correct location. Once the needles are in place, the physician injects the local anesthetic and/or steroid medication.

The procedure typically takes about 30 minutes to complete. After the procedure, the patient will be monitored for any adverse reactions. They may be discharged home the same day.

Are there any risks or side effects of a hypogastric plexus block?

HPB is a generally safe procedure, but there are some risks and side effects associated with it, including:

  • Allergic reaction to the medication
  • Nerve damage
  • Bleeding and bruising
  • Infection
  • Short-term numbness or weakness in the legs
  • Temporary difficulty urinating or passing stool
What are the results of a hypogastric plexus block?

Most patients experience pain relief within 15-20 minutes of the injection. The duration of pain relief varies from person to person, but it typically lasts for several hours to days. Some patients may experience long-term pain relief, especially if the block is repeated.

HPB is an effective treatment for chronic pelvic pain in many patients. It is a relatively safe and minimally invasive procedure, and it can provide significant pain relief for patients who have not responded to other treatments.


HPB may be repeated multiple times as needed. The number of injections required will vary depending on the patient's condition and response to treatment. HPB can also be combined with other treatments, which can help to optimize pain relief and improve quality of life.

If you experience chronic abdominal pain and would like to know if the hypogastric plexus block is right for you, make an appointment with us. We'll perform a full evaluation and create a treatment program for your unique situation.