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Superior Hypogastric Block and Neurolysis: Fluoroscopy, Ultrasound, Computed Tomography 

Superior Hypogastric Block and Neurolysis: Fluoroscopy, Ultrasound, Computed Tomography
Chapter:
Superior Hypogastric Block and Neurolysis: Fluoroscopy, Ultrasound, Computed Tomography
Author(s):

Kent H. Nouri

and Billy K. Huh

DOI:
10.1093/med/9780199908004.003.0035
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date: 23 August 2019

The superior hypogastric block (SHB) is an effective treatment for chronic or cancer-related pelvic pain. The CT-guided block offers the advantage of being able to visualize the target structure, soft tissue, disc, and bony structures to minimize complications. But CT has its own limitations such as being unable to visualize the needle at off angle, higher level of exposure to ionizing radiation, and longer procedure time compared to the fluoroscopy-guided procedure. Several variations to CT-guided techniques have been published. Each has its own advantages and disadvantages, but depending on the anatomical variations in spinal structure, any one of the techniques may be used. Fluoroscopy is used in the majority of superior hypogastric blocks because of the ease of use, availability, and quicker procedure times. The anterior approach to SHB using ultrasound guidance is useful technique in relieving pelvic pain in gynecological malignancies.

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