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Ganglion Impar block

What is the Ganglion of Impar?

The Ganglion of Impar is a bundle of nerves that sits in front of the tailbone but behind the rectum.  It is a sympathetic bundle of nerves that typically controls blood flow.

Am I a candidate for a Ganglion of Impar Block?

Typical condition(s) treated with a Ganglion of Impar block, include neuropathic perineal pain, or pain coming from the following organs:  rectum, anus, distal urethra, vulva, coccyx bone, and distal third of the vagina.  This pain is often times associated with malignancies.

How long does the procedure take?

The actual injection typical takes about 10 minutes.

What is injected?

Typically anesthetic and a steroid are injected.

Where is the procedure performed?

It is typically done in an office or surgical suite using fluoroscopy.

How is the procedure performed?

Typically an IV is started so that the anesthesiologist can administer sedating medication to make you comfortable.  Your doctor will typically identify the area he will be injecting using the X-ray machine, and then provide some local numbing medication (Lidocaine) before placement of the needle.  The needle is advanced using x-ray guidance along the vertebral body.  Needle position is confirmed with the injection of contrast dye, special technique, and the X-ray images.  The dye will not be used if there is an allergy.  Once needle placement is assured, the therapeutic solution is injected.

What if I am afraid of needles?

Typically patients with needle phobia do just fine with sedation to help relax them.  They also typically will have little to no memory of the actual procedure.

Is it painful?

Generally no, your doctor will do everything possible to minimize and discomfort during the procedure.  This may require sedation and is typically achieved with the numbing medication (lidocaine).

What are the risks and side effects?

The procedure is generally safe.  However, with any procedure or medications there are potential risk, complications, and side effects.  The most common side effects include temporary pain or soreness at the injection site. Uncommon risks include bleeding, infection, blood in the stool.

How many Ganglion of Impar Blocks will I require?

If you respond to the initial injection, it may be beneficial to have repeated injections.  Usually a series of injections is required to treat the problem and reverse the pain process.  Patient response is highly variable.

How long does the effect of the medication last?

The response is variable.  Typically the degree and duration of response increases with each additional injection.

What can I expect following the injection?

Some people report soreness at the injection site. Generally most people return to work the following day.