• Pain Med · Apr 2008

    Case Reports

    Computed tomography-guided bilateral transdiscal superior hypogastric plexus neurolysis.

    • Joshua Dooley, Christopher Beadles, Kok-Yuen Ho, Farrukh Sair, Linda Gray-Leithe, and Billy Huh.
    • Duke University Medical Center-Anesthesiology, Durham, North Carolina 27710, USA. Joshua.Dooley@duke.edu
    • Pain Med. 2008 Apr 1;9(3):345-7.

    ObjectiveThis report describes a case of computed tomography (CT)-guided bilateral posteromedian transdiscal approach to the superior hypogastric plexus with neurolysis for treatment of intractable abdominal pain secondary to metastatic prostate cancer. The case is considered in relation to other approaches described in the literature.DesignCase presentation and literature review.PatientsAn 83-year-old man with metastatic prostate cancer and intractable abdominal pain.InterventionsComputed tomography-guided bilateral posteromedian transdiscal neurolysis of the superior hypogastric plexus.ResultsPain reduction for intractable metastatic prostate cancer abdominal pain.ConclusionsNeurolysis of the superior hypogastric plexus is effective in treating metastatic prostate cancer abdominal pain. While there are significant risks to the CT-guided bilateral transdiscal approach to the superior hypogastric plexus, it may be used effectively as an alternative to navigate anatomic obstacles necessary to perform the neurolysis.

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