Fluoroscopy-guided transdiscal superior hypogastric plexus neurolytic block in chronic pelvic pain: A needle passing to the contralateral side

The superior hypogastric plexus (SHP) contains afferent nociceptive fibers from the pelvic structures, thus the SHP block is employed in the chronic pelvic pain (CPP) treatment in patients who do not respond to conservative treatments. A 60-year-old female patient, who did not respond to conservative treatment, underwent SHP neurolytic block after a successful diagnostic block. An excessive oblique angle approach was applied due to physical restrictions, the needle passed through the intervertebral disc resulting in the contralateral side SHP block, and the procedure was also repeated to the other side SHP. After the procedure, improvement in the patient’s NRS score and a decrease in urination frequency were detected, and these positive effects were preserved for 3 months. SHP block is a safe alternative interventional procedure in patients with CPP. If an excessive oblique angle is applied during the procedure, the needle may cross the midline, resulting in a contralateral blockage.