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Results for “HYPOGASTRIC PLEXUS”

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PubMedDate not supplied

Coaxial imaging technique for superior hypogastric plexus block.

BACKGROUND AND OBJECTIVES: Previously described techniques for superior hypogastric plexus (SHP) block are technically difficult. A simple coaxial imaging technique for SHP block is described. METHODS AND RESULTS: Fluoroscopic guidance for coaxial approach to SHP block is described. A successful block is easily achieved. CONCLUSIONS: A new approach to SHP block is described, which is technically effective. Other approaches involve more difficult needle angulations or use of computed tomography guidance. The coaxial technique avoids these issues and is easy to perform.

Humans↗
PubMed2001

Blockade of the superior hypogastric plexus block for visceral pelvic pain.

Visceral pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain independent of its etiology. Five major pathways by which pelvic pain is transmitted can be identified. One of them, the superior hypogastric plexus, an extension of the preaortic plexus, is easily assessable to blockade by local anesthetics and neurolytic agents. Several techniques have been described. Long-lasting pain relief with this procedure has been achieved in patients with pelvic cancer pain. However, there is a discrepancy between diagnostic and therapeutic blockade in patients with nonmalignant pain. Because a diagnostic blockade can give significant pain relief in a large variety of patients, it is worthwhile to investigate new methods that provide lasting neural blockade of the superior hypogastric plexus and long-lasting relief of this devastating condition.

Journal Article↗
PubMed1979

Denervation-like supersensitivity in the rat vas deferens induced by local application of colchicine to the hypogastric plexus.

In an attempt to induce denervation-like supersensitivity in the smooth muscle of the vas deferens without depriving the tissue of its innervation, a small amount of colchicine was locally applied to the hypogastric plexus of the rat. Colchicine produced supersensitivity and a partial depletion of the tissue norepinephrine. These effects were dose-dependent. The supersensitivity produced by colchicine was qualitatively and quantitatively similar to that induced by denervation. Following application of 20 micrograms of colchicine, the supersensitivity was fully developed by the 4th day. The supersensitivity began to decline by the 6th day but was measurable even after 16 days. Functional neuromuscular transmission was maintained even on the 4th day after colchicine application, although it was significantly less than the control. The time course of the development of supersensitivity was dependent on the length of the adrenergic nerve between the colchicine-applied site and the effector cells. The results indicate that supersensitivity is independent of an irreversible degeneration of the adrenergic nerves. The possible mechanisms of action of colchicine are discussed in relation to the known effects of colchicine on axoplasmic transport.

Animals↗
PubMed2004

Obstetric denervation-gynaecological reinnervation: disruption of the inferior hypogastric plexus in childbirth as a source of gynaecological symptoms.

Difficult vaginal deliveries damage branches of the inferior hypogastric plexus as they are distributed to the pelvic viscera. The initial denervatory injury is often asymptomatic. Nerve fibre proliferation along the course of damaged nerve trunks results in chaotic reinnervation of the visceral stroma and subsequent sensory pelvic symptoms including chronic pelvic pain, painful heavy periods, painful intercourse, urinary frequency and urgency, irritable bowel symptoms and vulval pain. Each symptom may be described as pain, or discomfort, in response to light touch (allodynia). In other visceral sites allodynic syndromes are frequently associated with aberrant neural repair. Nerve fibre proliferation has now been reported in every viscus in the female pelvis though its antecedents have not been established. It is proposed that clinical presentations with one, or more, sensory pelvic symptoms occur some years after a difficult intrapartum episode; the initial denervatory injury is succeeded by nerve fibre proliferation in the affected organs. The precise pathoanatomy, mechanisms of intrapartum injury and clinical presentation remote from the intrapartum episode, may have obscured the common aetiology of many sensory pelvic syndromes.

Denervation↗