Celiac Plexus Block and Superior Hypogastric Plexus Block

Fluoroscopic-Guided Bilateral Superior Hypogastric Plexus Neurolysis in the Treatment of Intractable Neoplasm-Related Penile Pain

“…This fourth step is implemented when the analgesic ladder therapy fails to alleviate the pain and/or produces dangerous side effects. At this point, invasive procedures and therapy can be used, including nerve blocks, neurolysis, epidural analgesia, ablative procedures, cementoplasty, as well as palliation radiotherapy [4][5][6][7][8]. In this case presentation, the WHO analgesic ladder was followed in a progressive fashion until the more invasive option of neurolysis was considered.…”

“…Studies have shown that both locally advanced and metastatic penile cancer, along with its associated management options and subsequent complications, yield a very poor prognosis, with pain being the most feared symptom. Furthermore, a lack of palliative therapy has been demonstrated in this patient population, with an emphasis on the need for implementing future options [2][3][4][5][6]. To the authors' knowledge, this will be the first documented case of the successful utilization of a bilateral superior hypogastric plexus neurolysis in the management of intractable neoplasmrelated penile pain attributed to both radiation-induced injury in the treatment of malignant neoplasm and penile pain secondary to metastatic prostate cancer to the penis.…”