The efficacy of the ganglion impar block in perineal and pelvic cancer pain

Correia, Joana Sousa; Silva, Manuel; Castro, Clara; Miranda, Lina; Agrelo, Ana Isabel Boullón

doi:10.1007/s00520-019-04738-9

Cited by 20 publications

(5 citation statements)

References 20 publications

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“…In some cases, coccydynia may result from a remote process that is perceived as occurring at the coccyx (referred pain) or involving the nerves which provide nociception for the sacrococcygeal region. Referred pain is not uncommon with pelvic malignancies and is a common indication to perform a ganglion impar block or ablation (36). Neurogenic pain typically stems from the upper lumbar spine, with upper lumbar disc disease or other disease in the upper lumbar region being a potential cause of coccydynia that warrants consideration and possible investigation (37).…”

Section: Referred and Neurogenicmentioning

confidence: 99%

Imaging Coccygeal Trauma and Coccydynia

et al. 2020

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The coccygeal region has complex anatomy, much of which may contribute to or be the cause of coccyx region pain (coccydynia). This anatomy is well depicted at imaging, and management is often dictated by what structures are involved. Coccydynia is a common condition that is known to be difficult to evaluate and treat. However, imaging can aid in determining potential causes of pain to help guide management. Commonly, coccydynia (coccygodynia) occurs after trauma and appears with normal imaging features at static neutral radiography, but dynamic imaging with standing and seated lateral radiography may reveal pathologic coccygeal motion that is predictive of pain. In addition, several findings seen at cross-sectional imaging in patients with coccydynia can point to a source of pain that may be subtle and easily overlooked. Radiology can also offer a role in management of coccygeal region pain with image-guided pain management procedures such as ganglion impar block. In addition to mechanical coccyx pain, a host of other conditions involving the sacrococcygeal region may cause coccydynia, which are well depicted at imaging. These include neoplasm, infection, crystal deposition, and cystic formations such as pilonidal cyst. The authors review a variety of coccydynia causes, their respective imaging features, and common management strategies. ©

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Section: Referred and Neurogenicmentioning

confidence: 99%

Imaging Coccygeal Trauma and Coccydynia

et al. 2020

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“…36,37 Blocks to the superior hypogastric plexus for pelvic pain from gynecologic and urologic malignancies and to the ganglion impar (ganglion of Walther) for perineal pain secondary to anorectal tumors have been shown to resolve pain. 38,39 Injection can be done into the intrathecal space to achieve segmental pain control without affecting motor function. 40…”

Section: ■ What Interventional Procedures Are Available For Cancer Pain?mentioning

confidence: 99%

Frequently asked questions about managing cancer pain: An update

Samala

Lagman

Najafi

et al. 2021

CCJM

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Most patients with cancer experience pain at some point in the disease course due to the disease itself or its treatment, or both. Pain management can involve pharmacologic (nonopioid medications, adjuvants, and opioids) and nonpharmacologic (radiation therapy, interventional procedures) therapies. This article provides a treatment approach to reduce pain for patients with cancer and improve their quality of life. KEY POINTS Cancer pain affects patients throughout the disease trajectory. The typical pharmacologic regimen for treating patients with cancer pain consists of an assortment of nonopioid analgesics, adjuvant pain medications, and opioids. Early consideration of radiation therapy and various interventional pain management procedures can optimize pain control and preclude escalation of opioids. New or worsening pain in patients with a history of cancer requires thorough assessment for cancer recurrence or progression.

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“…Injections are usually given into the sacrococcygeal junction or around the sacrococcygeal ligaments. The ganglion impar block can be used in refractory cases as well as in those associated with malignant neoplasm pain [ 6 ]. Surgical amputation of the coccyx just proximal to the sacrococcygeal junction is associated with a high complication rate and failure to relieve the pain.…”

Section: Discussionmentioning

confidence: 99%

Navigated Dorsal Root Ganglion Stimulation (DRGS) for the Treatment of Chronic Refractory Coccygodynia: A Case Report

Santiago¹,

Mônaco²,

Piedade³

et al. 2023

Cureus

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Sacral stimulation is a well-established therapy for urologic neuromodulation. After the advent of dorsal root ganglion (DRG) stimulation, pain surgeons have started to reach this target mostly for pelvic and sacral pain. For those without good surgical experience, sacral foramen puncture, especially S3 and S4, can be a challenge, due to its entry angle and limited C-arm image resolution. In this report, we describe a new technique to utilize sacral navigation using the O-arm approach to guide DRG stimulation implants. We discuss a case of a 53-year-old male patient with refractory coccygodynia, who underwent sacral DRG implantation using neuronavigation. Punctures could be done without the need for multiple attempts to reach the foramen in this patient.

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The efficacy of the ganglion impar block in perineal and pelvic cancer pain

Cited by 20 publications

References 20 publications

Imaging Coccygeal Trauma and Coccydynia

Imaging Coccygeal Trauma and Coccydynia

Frequently asked questions about managing cancer pain: An update

Navigated Dorsal Root Ganglion Stimulation (DRGS) for the Treatment of Chronic Refractory Coccygodynia: A Case Report

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