An Evaluation of Superior Hypogastric Plexus Block in Treatment of Pain in Patients with Endometriosis Resistant to Medical and Surgery Therapies: A randomized clinical trial

Background: Despite the new surgical and medical therapies, an effective pain management has not been developed for the patients with endometriosis. The objective of this study was to investigate the efficacy of superior hypogastric plexus (SHP) block in relieving pain and improving quality of life in the patients with endometriosis.Methods: In this randomized clinical trial, 32 patients with endometriosis who had already undergone laparoscopy and received medical therapy for pain with mean visual analog scale (VAS) score of more than 5 were divided into two groups of intervention and control. The intervention group received SHP block. The following information were collected from both groups before intervention: age, body mass index (BMI), additional diseases, mean pain (menstrual pain, cyclic pelvic pain and dyspareunia) VAS scores, and Oswestary disability index (ODI) questionnaire. Both group were also evaluated using VAS score and ODI questionnaire in the intervals of 1, 4, 12, and 24 weeks after injection. Results: Based on our findings, there was a significant reduction in pain associated with dysmenorrhea, dyspareunia, and chronic pelvic pain (CPP) in the patients of intervention group using VAS scores (p˂0.0001). In addition, after use of SHB block, there was a statistically significant increase in quality of life in terms of daily life activities and social skills during follow- up (p˂0.0001).Conclusion: SHP block is considered as an effective method in treatment of pain and improvement of quality of life in patients with endometriosis who are resistant to surgical and medical therapies.Significance:Endometriosis is a gynecologic disease which presents with dysmenorrhea, dyspareunia and chronic pelvic pain. Based on our findings SHP block is considered as an effective method in treatment of pain and improvement of quality of life in patients with endometriosis.