Abstract No. 394 - CT-guided diagnostic superior hypogastric plexus block and alcohol ablation treatment for nonmalignant chronic pelvic pain

Abstract

Purpose To describe our initial experience with image-guided superior hypogastric plexus (SHGP) block for diagnosis and with alcohol ablation for treatment of patients with chronic nonmalignant pelvic pain. Materials and Methods Eight women (average age = 44 ± 11.5 y, range 32-68 y) make up the study group. Pretreatment pain assessment was routinely performed using the Visual Analogue Scale (VAS), Chronic Pain Index, and short-form McGill (SF-McGill) pain questionnaires and Sf-12v2 QOL questionnaires. After IRB approval a review of the medical record was performed to collect pretreatment survey data. All patients underwent diagnostic CT-guided SHGP blockade with Bupivicaine. A subgroup of patients reported a decrease in symptoms of pelvic pain with the diagnostic SHGP block. These patients were subsequently offered treatment with CT-guided alcohol ablation of the superior hypogastric nerve plexus. Three have undergone the procedure. Results No adverse events or complications were noted. Average time to follow-up after SHGP block was 92 days. Long-term follow-up data will be obtained via review of posttreatment pain assessment instruments. Surgical and gynecologic medical histories as well as clinical follow up will be reviewed. Conclusion SHGP blockade can alleviate chronic pain in patients with deep pelvic pain. Alcohol ablation of the SHGP has been used in patients with malignant pelvic pain and has potential utility in patients with nonmalignant chronic pelvic pain. We will present our experience in treating the initial 3 patients as well as a series of upcoming patients with nonmalignant pelvic pain.