Overview
The hypogastric plexus is a network of sympathetic nerves involved in transmitting pain signals from pelvic organs such as the bladder, uterus, prostate, and rectum. When these pathways become sensitised, pain may feel deep, persistent, and difficult to localise. This can occur with endometriosis, chronic bladder pain syndromes, post surgical pelvic pain, inflammatory pelvic conditions, or longstanding pelvic pain with nerve sensitisation.
A hypogastric plexus block aims to calm this pathway using local anaesthetic, sometimes with steroid medication, and can help confirm whether the plexus contributes to symptoms when improvement occurs after 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 after 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.
What Is a Hypogastric Plexus Block
A targeted injection delivered near the hypogastric plexus using imaging guidance, commonly CT guidance or X ray guidance depending on the approach. The injection typically includes:
• Local anaesthetic to reduce nerve signalling
• Steroid medication in selected cases to reduce inflammation
This treatment can provide diagnostic insight and therapeutic benefit, supporting a broader treatment plan.
What to Expect During the Procedure
You will be positioned comfortably depending on technique. The skin is cleaned and numbed, then a fine needle is guided into place using imaging. Medication is delivered near the plexus and you are monitored before discharge.
After the Procedure
Mild soreness can occur at the entry site. Some people notice early relief from the local anaesthetic, while steroid benefit may build over 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
• Temporary increase in pain
• Local bruising or soreness
• Lightheadedness in some cases
• Infection rare
• Bleeding
• Allergic reaction uncommon
• Very rarely irritation of nearby structures
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 approach.
Safety Note
Inform your consultant about blood thinners, allergies, diabetes, pregnancy, and recent infections. Avoid driving if numbness or dizziness persists.
Arrange a consultation to discuss whether a hypogastric plexus block may help.