Overview
Hypogastric plexus block is a targeted treatment used when deep pelvic pain is linked to sympathetic nerve pathways supplying the pelvic organs. The hypogastric plexus is a network of nerves involved in transmitting pain signals from organs such as the bladder, uterus, prostate, and rectum.
When these pathways become sensitised, pain may feel deep, persistent, and difficult to localise. This may occur in conditions such as endometriosis, chronic bladder pain syndromes, post surgical pelvic pain, inflammatory pelvic conditions, or longstanding pelvic pain associated with nerve sensitisation.
A hypogastric plexus block aims to calm these nerve pathways using local anaesthetic, sometimes combined with steroid medication. The treatment may also help confirm whether the hypogastric plexus contributes to symptoms when pain improves after the injection.
Who this treatment helps
A hypogastric plexus block may be suitable for people with:
- Deep pelvic pain with suspected organ related pain pathways
- Endometriosis related pelvic pain
- Bladder pain syndromes or urinary pain patterns
- Pain following pelvic surgery
- Chronic pelvic pain syndrome in selected cases
- Rectal or deep lower abdominal pain patterns
- Limited benefit from medication or physiotherapy
A consultation is required to confirm suitability and determine whether the hypogastric plexus may be contributing to symptoms.
What is a hypogastric plexus block
A hypogastric plexus block is a targeted injection delivered near the hypogastric plexus using imaging guidance. CT guidance or X ray guidance may be used depending on the technique and the safest approach.
The injection typically contains:
- Local anaesthetic to reduce nerve signalling
- Steroid medication in selected cases to reduce inflammation
This treatment can provide both diagnostic insight and therapeutic benefit, helping guide the overall pelvic pain management plan.
What to expect during the procedure
Your consultant will explain the treatment plan and answer any final questions before the procedure begins.
- You are positioned comfortably depending on the technique used
- The skin is cleaned and numbed with local anaesthetic
- A fine needle is guided into position using imaging guidance
- Medication is delivered near the hypogastric plexus
- You are monitored briefly before discharge
The procedure is usually performed as a day case and takes a short time to complete.
After the procedure
Mild soreness may occur at the entry site after the injection. Some people notice early improvement from the local anaesthetic, while steroid benefit may develop gradually over several days.
Your consultant may advise:
- Avoid strenuous activity for 24 to 48 hours
- Continue pelvic floor therapy or rehabilitation if recommended
- Monitor symptoms and report any concerns
Benefits
- May reduce deep pelvic pain
- Helps clarify pain pathway involvement
- Minimally invasive with short recovery time
- Can improve daily comfort and function
- May reduce reliance on medication
- Supports multidisciplinary pelvic pain management
Possible risks and side effects
Hypogastric plexus block is generally safe when performed by experienced clinicians, although all procedures carry some risk.
- Temporary increase in pain
- Local bruising or soreness
- Lightheadedness in some cases
- Infection, which is rare
- Bleeding
- Allergic reaction, uncommon
- Very rarely irritation of nearby structures
Your consultant will explain the expected benefits, possible risks, and alternative options during your assessment.
When to consider other options
If symptoms do not improve or involve different pain pathways, your consultant may discuss pudendal nerve block, ganglion impar block, caudal epidural, medication optimisation, or a multidisciplinary pelvic pain management plan.
Safety note
Please inform your consultant about blood thinning medication, allergies, diabetes, pregnancy, or recent infection before treatment. Avoid driving if numbness or dizziness persists after the procedure.
Arrange a consultation to discuss whether a hypogastric plexus block may help relieve your pelvic pain.
You can also explore our pelvic pain treatments, learn more about pudendal nerve block, ganglion impar block, genitofemoral nerve block, or view all pain treatments.