Superior hypogastric plexus block using a single needle and computed tomography guidance: description of a modified technique

Block of the superior hypogastric plexus has been advocated as a useful technique in the palliation of pain secondary to pelvic malignancies, endometriosis, chronic benign pelvic pain, and proctalgia fugax. Traditionally, this technique has been performed under fluoroscopic guidance using bilateral placement of needles. We describe a modification of that technique that allows successful hypogastric plexus block using a single needle placed under computed tomography guidance. Our experience suggests that computed tomography guidance allows easier, safer, and more accurate needle placement, obviating the need for the placement of the second needle when performing superior hypogastric plexus block.