Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Feb;13(2):51-55.
doi: 10.14740/jmc3800. Epub 2022 Feb 16.

Superior Hypogastric Plexus Neurolysis to Manage Metastatic Pelvic Pain in a Forty-Five-Year-Old Spina Bifida Patient: A Case Report

Somnath Bagchi  1   2 , Rosie Kemp  3 , Christopher J Green  1 , Jeffrey Stephenson  4
Affiliations
Case Reports

Superior Hypogastric Plexus Neurolysis to Manage Metastatic Pelvic Pain in a Forty-Five-Year-Old Spina Bifida Patient: A Case Report

Somnath Bagchi et al. J Med Cases. 2022 Feb.

Abstract

A 45-year-old patient with spina bifida and adenocarcinoma of the rectum was treated with a superior hypogastric plexus (SHP) ablation for pain control. The procedure enabled her to reduce opioid consumption, being more clear-headed and functional to be discharged to her residence. The case is presented to highlight the options of neurolytic interventions to manage pain in terminally ill cancer patients. We discuss the options of SHP ablation and justify our choice of approach and the use of a neurolytic agent.

Keywords: Cancer pain; Neurolysis; Spina bifida; Superior hypogastric plexus neurolytic block.

PubMed Disclaimer

Conflict of interest statement

None to declare.

Figures

Figure 1
Figure 1
MRI of the lumber and sacral spine showing the metastatic deposit and the extent of the disease. MRI: magnetic resonance imaging.
Figure 2
Figure 2
Lateral view of lumbar and sacral spine with needles in front of lower past of body of L5.
Figure 3
Figure 3
Fluoroscopic AP view with needle in position with contrast. Contrast (short lines) shows hypogastric plexus. AP: anterior-posterior.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manage. 2016;51(6):1070–1090.e9. doi: 10.1016/j.jpainsymman.2015.12.340. - DOI - PubMed
    1. Duarte RV, Sale A, Desai P, Marshall T, Eldabe S. The unmet need for intrathecal drug delivery pumps for the treatment of cancer pain in England: an assessment of the hospital episode statistics database. Neuromodulation. 2020;23(7):1029–1033. doi: 10.1111/ner.13264. - DOI - PubMed
    1. Bennett MI, Eisenberg E, Ahmedzai SH, Bhaskar A, O'Brien T, Mercadante S, Krcevski Skvarc N. et al. Standards for the management of cancer-related pain across Europe - A position paper from the EFIC task force on cancer pain. Eur J Pain. 2019;23(4):660–668. doi: 10.1002/ejp.1346. - DOI - PMC - PubMed
    1. Candido KD, Kusper TM, Knezevic NN. New cancer pain treatment options. Curr Pain Headache Rep. 2017;21(2):12. doi: 10.1007/s11916-017-0613-0. - DOI - PubMed
    1. Rocha A, Plancarte R, Nataren RGR, Carrera IHS, Pacheco V, Hernandez-Porras BC. Effectiveness of superior hypogastric plexus neurolysis for pelvic cancer pain. Pain Physician. 2020;23(2):203–208. doi: 10.36076/ppj.2020/23/203. - DOI - PubMed

Publication types

LinkOut - more resources