Ganglion Impar Block
What is ganglion impar block?
Ganglion impar block is an excellent way to treat chronic, neuropathic perineal pain from visceral or sympathetic pain syndromes, especially if they are secondary to malignancy. Since the ganglion impar receives afferent pain fibers from the perineum, distal rectum, anus, distal urethra, vulva, and distal third of the vagina, this block can potentially alleviate pain originating from the above-mentioned regions.
Who is a good candidate for ganglion impar block?
If you have vague, poorly localized perineal pain that is frequently accompanied by sensations of burning or urgency, you may benefit from this block. However, since the symptoms of burning and urgency, especially if they’re associated with urination or defecation, may be secondary to a medical condition, it’s important to first consult your primary care doctor to make sure you are not experiencing perineal area pain from one of these causes.
Since the ganglion impar receives afferent pain fibers from the perineum, distal rectum, anus, distal urethra, vulva, and distal third of the vagina, this block can potentially alleviate pain originating from the above-mentioned regions. The most recent literature highlights that the ganglion impar block has also been used successfully to treat non-malignancy-associated perineal pain from various etiologies, including sacral postherpetic neuralgia, spinal cord malformations, and failed back surgery syndrome, to name a few.
How ganglion impar block works
The sympathetic nervous system (SNS) plays a big role in neuropathic pain. Therefore, the ability to selectively block portions of the SNS has proven helpful in treating certain types of pain (i.e. - pain that is unresponsive to conventional therapies). The block is performed by injecting a small amount of anesthetic into the ganglion of impar. This causes signals between the SNS and pain fibers to become interrupted, leading to relief. The procedure is typically short, minimally-invasive, and a local anesthetic is usually administered.