Computed Tomography-Guided Superior Hypogastric Plexus Block for Secondary Dysmenorrhea in Perimenopausal Women

BACKGROUND Refractory abdominal pain during menstruation severely affects patients' quality of life and simultaneously places enormous psychological burdens on patients and their families. Several treatments for secondary dysmenorrhea are available; however, none can permanently treat all types of secondary dysmenorrhea. Since pain is transmitted by the nerves, we hypothesized that a neurolytic block could be used as a treatment for refractory abdominal pain during menstruation. We sought to investigate the therapeutic efficacy and safety of computed tomography (CT)-guided superior hypogastric plexus block for secondary dysmenorrhea. MATERIAL AND METHODS We performed CT-guided neurolytic block of the superior hypogastric plexus by bilaterally administering 4 mL of a dehydrated alcohol solution in 25 patients from January 2014 to February 2016. The degree of pain and its impact on the patients' mood and quality of life were evaluated using the visual analogue scale, Hospital Anxiety and Depression Scale, and 36-Item Short Form Survey before and after therapy, and the data were statistically analyzed using analysis of variance and t test. RESULTS The degrees of pain were significantly (p<0.05) decreased after neurolytic block (from 7.74±1.14 to 2.96±1.55). The patients showed significantly (p<0.05) less anxiety and improved bodily pain with mental health status. CONCLUSIONS Secondary dysmenorrhea can be effectively and safely treated with a neurolytic block of the superior hypogastric plexus.