Chronic pelvic pain (CPP) is persistent lower abdominal pain that

persists for longer than 6 months. It severely affects patients’

quality of life as well as their mental health. It also carries a

significant economic and social burden, making effective

management crucial. Superior hypogastric block (SHB) is

considered a safe, minimally invasive procedure that has proven

to be effective in treating CPP, with a success rate of 70 - 80%.

Endometriosis, a leading cause of CPP, affects 6-10% of women of

reproductive age, 35 - 50% of those suffer with pain or infertility. In

the UK 1.5 million women suffer from endometriosis, costing the

UK economy £8.2 billion annually. This study underscores the

critical need for greater awareness, timely diagnosis, and

accessible treatments.

RESULTS

All patients were of White British ethnicity, aged between 24 and 41 years, with a BMI of less than

32. Recorded pre-procedure pain scores were above 5 out of 10. Primary indication for SHB was

CPP secondary to endometriosis. Of the seven women, five had undergone prior surgical

interventions, and three of five had received additional hormonal treatments. Ultrasound reports

were available for three women: two had normal findings, while one showed evidence of

adenomyosis and endometriosis. MRI results were normal in four women, whereas two showed

adenomyosis and endometriosis. No intra- or post-procedure complications were reported.

Post-procedure outcomes indicated that three women experienced symptom improvement, two

showed no improvement (one subsequently underwent hysterectomy, and the other had

laparoscopy followed by hormonal treatment), and no outcome data were recorded for the

remaining two women.

DESIGN

A prospective observational clinical study aims to evaluate a novel

treatment for endometriosis by blocking nerve pathways

associated with pelvic pain at King’s College Hospital NHS

Foundation Trust. To assess the effectiveness of SHB in alleviating

symptoms and improving the quality of life for those suffering from

endometriosis-related chronic pelvic pain, providing valuable

insights into this promising treatment approach.

METHODS

Prospective recruitment of women with CPP caused by severe

endometriosis was conducted to assess the effect of SHB. Seven

women chose to undergo the procedure, following the

introduction of the SHB service at the trust.

CONCLUSION

SHB offers a potential option for managing refractory CPP, but our small sample size limits

definitive conclusions. In our cohort, 42.8% of women showed improvement, highlighting the

need for larger number to validate these findings. Future studies with a larger sample size would

be beneficial in assessing SHB and its effect on refractory endometriosis pain.