Superior Hypogastric Plexus Combined with Ganglion Impar Neurolytic Blocks for Pelvic and/or Perineal XXXX Relief.

@entity1 @entity5 @entity3971 @entity158 @entity1286 @entity616
BACKGROUND: The superior hypogastric plexus (SHGP) carries afferents from the viscera of the lower abdomen and pelvis. @entity616 of this plexus is used for reducing @entity158 resulting from @entity5 in these organs. The ganglion impar (GI) innervats the perineum, distal rectum, anus, distal urethra, vulva, and distal third of the vagina. Different approaches to the ganglion impar neurolysis have been described in the literature. OBJECTIVES: To assess the feasibility, safety, and efficacy of combining the block of the SHGP through the postero-median transdiscal approach with the @entity616 by the trans-sacro-coccygeal approach for relief of pelvic and/or perineal @entity158 caused by pelvic and/or perineal @entity5 or any @entity5 related causes. METHODS: Fifteen @entity1 who had @entity5 -related pelvic @entity158 , or both received a combined SHGP @entity616 through the postero-median transdiscal approach using a 20-gauge Chiba needle and injection of 10 mL of 10% @entity3971 in saline plus a GI @entity616 by the trans-sacro-coccygeal approach using a 22-gauge 5 cm needle and injection of 4 - 6 mL of 8% @entity3971 in saline. @entity158 intensity (measured using a visual analogue scale) and oral @entity1286 consumption pre- and post-procedure were measured. RESULTS: All @entity1 presented with @entity5 . @entity158 scores were reduced from a mean (   SD) of 7.87    1.19 pre-procedurally to 2.40    2.10 one week post-procedurally (P < 0.05). In addition, the mean consumption of @entity1286 (delivered via 30 mg sustained-release @entity1286 tablets) was reduced from 98.00    34.89 mg to 32.00    28.48 mg after one week (P < 0.05). No complications or serious side effects were encountered during or after the block. LIMITATIONS: This study is limited by its small sample size and non-randomized study. CONCLUSION: A combined neurolytic SHGP block with @entity616 is an effective and safe technique for reducing @entity158 in @entity5 @entity1 presented with pelvic and/or perineal @entity158 . Also, a combined SHGP block through a posteromedian transdiscal approach with a @entity616 through a trans-sacrococcygeal approach may be considered more effective and easier to perform than the recently invented bilateral inferior hypogastric plexus neurolysis through a transsacral approach.
