title: Computed tomography-guided bilateral transdiscal superior hypogastric plexus neurolysis.
abstract: OBJECTIVE
  This 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.
  
  
  METHODS
  Case presentation and literature review.
  
  
  METHODS
  An 83-year-old man with metastatic prostate cancer and intractable abdominal pain.
  
  
  METHODS
  Computed tomography-guided bilateral posteromedian transdiscal neurolysis of the superior hypogastric plexus.
  
  
  RESULTS
  Pain reduction for intractable metastatic prostate cancer abdominal pain.
  
  
  CONCLUSIONS
  Neurolysis 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.
authors: Duke University Medical Center-Anesthesiology, Durham, North Carolina 27710, USA. Joshua.Dooley@duke.edu
authors: Joshua
authors: J
authors: Dooley
authors: Christopher
authors: C
authors: Beadles
authors: Kok-Yuen
authors: KY
authors: Ho
authors: Farrukh
authors: F
authors: Sair
authors: Linda
authors: L
authors: Gray-Leithe
authors: Billy
authors: B
authors: Huh
mesh_terms: D000369:Aged, 80 and over; D001340:Autonomic Nerve Block / Q000379:methods*; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000150:complications; D014057:Tomography, X-Ray Computed