Superior Hypogastric Plexus Block

What is the superior hypogastric plexus?

The superior hypogastric plexus is located in the retroperitoneal space, at the back of the abdomen. It consists of a network of nerve cells, which extends on both sides of the body, from the 3rd to the 5th lumbar vertebra and the 1st sacral vertebra. This plexus innervates the pelvic organs – including the bladder, urethra, prostate, anus, uterus, and genitals.


Superior hypogastric plexus block is one of the techniques available to stop and block pain signals from areas of the sympathetic nervous system. Stopping pain signals from the superior hypogastric plexus can help in pain relief and management in the areas covered by the plexus.

What is a superior hypogastric plexus block?

How is it performed?

Superior hypogastric plexus block is performed by injecting anesthetic into the area. The whole procedure is CT-guided to confirm needle position. Sometimes, in addition to the anesthetic, alcohol or phenol are also given for the purpose of neurolysis (destroying the plexus).
In recent years, radiofrequencies have been used to perform neurolysis in an effort to reduce potential complications and provide longer-lasting pain relief.

Indications for a superior hypogastric plexus block

Superior hypogastric plexus block is a method especially designed to address pain in the pelvic area.

How is it performed?

• Neuropathic pain in the penis
• Diseases affecting the reproductive organs
• Malignancy-related chronic pelvic pain
• Anal pain
• Endometriosis
• Descending colon pain
• Colorectal cancer
• Urinary tract cancer
• Gynecological cancer
• Radiation-induced muscle or nerve injury

Possible complications with a superior hypogastric plexus block

The risk of complications during a superior hypogastric plexus block is very low. The following risks could theoretically arise during the procedure:
• Bleeding
• Nerve tissue injury
• Perforation of adjacent organs
• Peripheral ischemia