Medical

The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a plexus of nerves situated on the vertebral bodies below the bifurcation of the aorta.

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Structure

The superior hypogastric plexus is situated in front of the last lumbar vertebra and the promontory of the sacrum, between the two common iliac arteries, and is formed by the union of numerous filaments, which descend on either side from the aortic plexus, and from the lumbar splanchnic nerves; it divides, below, into two lateral portions which travel inferiorly as the so-called hypogastric nerves, which end as the inferior hypogastric plexus. The superior hypogastric pleux has contributions to the ureter and epididymis.

Superior Hypogastric Plexus Block

by Elizabeth Cudilo M.D, Paul Lynch M.D, and Tory McJunkin M.D

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A superior hypogastric plexus block is a type of injection that is used to control pelvic pain that does not respond to oral medications. This block can also be indicated if the side effects for a pain relieving medication (excessive nausea, constipation, and sedation) are unacceptable to the patient. Since the superior hypogastric plexus contains efferent sympathetic fibers to and afferent pain fibers from the bladder, urethra, uterus, vagina, vulva, perineum, prostate, penis, testes, rectum, and descending colon, this block can potentially alleviate pain originating from the above mentioned regions. The most recent literature highlights that the superior hypogastric plexus block has been used successfully to treat both malignancy-associated anal-rectal pain18 and nonmalignant penile pain14, which further adds evidence for the applications of this block.

Pain originating from:

Bladder

Urethra

Uterus

Vagina

Vulva

Perineum

Prostate

Penis

Testes

Rectum

Descending colon

Pain secondary to:

Cancer that metastasized to the pelvis (cervical, prostate, testicular, colorectal etc.)

Endometriosis

Radiation Injury...