Targeted pain treatment for buttocks pain and stool passage pain

What is a ganglion Impar procedure?

When a patient suffers from rectal pain or old pelvic pain, our pain expert doctors usually stop the pain signal to the brain, by a common procedure known as Ganglion Impar treatment. This type of procedure is performed on patients that suffer from cancer (metastasized) or tailbone pain. The ganglion impar nerve is situated behind the tailbone (coccyx).

As of today, the most effective method of performing such a procedure is known as the transsacrococcygeal approach.

When should I consider having a ganglion impar procedure?

The ganglion impar procedure is most often used when doctors have to treat symptoms associated with back pain or chronic pain in and around stool passage or pain in bottom or rectal pain, either visceral or sympathetic or neuropathic. The procedure can be applied especially on patients that suffer from localized perineal pain. These are very common pain locations in patients suffering from rectal cancer or colorectal cancer, cervical cancer and vaginal cancer.

Ganglion impar procedure can be beneficial for other symptoms related to cancer of several organs such as the anus, urethra, perineum, vulva or rectum. Such symptoms may include pain associated with a burning heat sensation, difficulty in sitting, or severe pain while passing stool. But pain is just a signal produced by the brain as a response to a discomforting situation, and a pain intervention will stop the signal to reach the brain, this way reducing the patient’s pain and symptoms. Radiotherapy to pelvic organs or rectum or anus ie stool passage is also known to cause severe pain.

What should I expect after the procedure takes place?

The procedure method used (trans-coccygeal joint or paramedical technique) and result of a ganglion impar procedure will depend on the location of the ganglion impar in the body, its size and shape. Since this varies from patient to patient, the result varies as well. A needle like instrument, called probe is used to reach the ganglion. It can be passed from underneath the tail bone or may be passed directly through the actual sacrum/coccyx joint or tailbone joint.

Once the procedure is performed, the patient needs to rest for half an hour in the recovery room before going back home. If the procedure is successful, then the patient will experience an immediate pain relief, which will last long.

Is there anything else I need to know?

When considering such a procedure, it is important to know that if you are currently taking any blood thinners medication or anything similar or have been administered anything similar seven days prior to the ganglion impar procedure, it is advisable that you do not go ahead with the procedure, since it becomes risky.

If you follow instructions of your pain management specialist doctor , the ganglion impar procedure should not have any considerable side effects. In some rare situations, patients were allergic to the administered medication, or bleeding or infection at the location of the procedure.

What happens when a ganglion impar procedure is done?

Before doing actual procedure, test procedure is done, known as ganglion impar procedure. In test procedure, numbing medicine is given in the plexus. If that relieves your pain more than 50% immediately, it’s a clue to go for actual ganglion impar procedure.

Patients need to lie down on the belly on the procedure table. Procedure is always done with the help of x-ray machine or CT machine or ultrasound machine for accurate targeting of ganglion impar plexus. Skin over the lower back is made numb. Through that numb skin, a needle like instrument (known as probe) is inserted and paced near the plexus. Neurolysis or RF ablation can be done then.

Will the procedure hurt?

The ganglion impar procedure does involve the insertion of a needle like instrument, called probe through the skin and deeper tissues, so there is a slight discomfort. However, the skin and tissues are numbed with a local anesthetic medicine give through a small needle.

How is the ganglion impar procedure performed?

The ganglion impar procedure only takes around 30 minutes to perform, but there is some pre work. You will be made to lie down on your belly, will cleanse your back with an antiseptic solution.

Using an x-ray machine (fluoroscope), the specialist doctor can visualize the tailbone to guide the probe to the correct spot. Mixture of medications is given or RF ablation is done.

What can I expect after the procedure?

Immediately after the procedure, you may possibly feel immediate relief of pain due to the local anesthetic. However, this only lasts a few hours. Your pain will return and you can experience pain relief again over the next few days.

How long does the effect of the procedure last?

Depending on the medication used, relief can last from few weeks to many months. The location, shape, and size of the ganglion impar nerves vary from person t  o person. Because of these factors, there is a possible risk that the procedure may have to be repeated.

What results can I expect after the ganglion impar procedure?

After  ganglion impar procedure on rectal pain, the majority of patients reported a reduction in pain scores immediately after the procedure, and they maintained this relief for many months.

How beneficial is ganglion impar procedure?

ganglion impar procedure is found to provide pain relief between a few weeks and a year subject to patient condition and spread of the cancer. And usually it is the only method left to provide pain relief (except pain implant) when other commonly used methods fail. Most important criteria for the better outcome is the timing of the procedure. Earlier the procedure is done, better is the results.

The procedure significantly reduces the dependence on pain medication while improving the quality of life.

Click on Superior hypogastric plexus to understand the targeted treatment required to treat pelvic pain in uterus cancer, ovary cancer and urinary bladder cancer.

What is a neurolytic ganglion impar procedure

For the neurolytic superior hypogastric plexus intervention, we will use a concentrated medicated neurolytic medicine mixed with some numbing medicine. In contrast to the numbing medicine this neurolytic medicine will actually destroy the pain nerves. These selectively damaged pain nerves will not be able to let you feel the pain for a much longer time. It is very important to understand here that, this procedure does not affect the other normal roles of nerves or other nerves. At stage 3 or stage 4 cancer, neurolysis is desirable and the right treatment. Click ascitis and stoma care at home to know the best supportive care at home for colostomy stoma along with pain relief.

What is a Radiofrequency Ablation of Nerve?

Radiofrequency ablation of nerve or radio frequency lesion is a procedure using a specialized machine to interrupt the pain signals on a semi-permanent basis.

The basic principle of radio-frequency lesioining is placement of an insulated electrode probe into the target tissue or pain nerves and release RF waves.

When is the radiofrequency ablation of nerve used?

Radiofrequency ablation of nerve is generally used for patients with who all forms of commonly used pain medications are not giving satisfactorily pain relief. That means common methods of pain relief have failed.

Radiofrequency ablation of ganglion impar procedure is generally advised for patients experiencing one of the below listed medical conditions:

Rectal pain because of intestinal cancer, colon cancer, rectal cancer, colorectal cancer, cervical cancer, vaginal cancer, vulval camcer, uterus cancer etc.

In addition, to be a right candidate for radiofrequency ablation of ganglion impar, you must have responded well to the local anesthetic test block. ie before doing an RFA procedure, numbing medicine is given in the target pain nerves and if you get more than 50% pain relief immediately, its an indication to proceed for the radiofrequency ablation procedure. These two steps may be done on the same day or on different days, depending upon the patient’s condition and requirement.

What is the procedure?

The radiofrequency nerve ablation uses radio waves to produce heat directed at a specific pain nerve. The heat destroys the nerve and thus relieves pain. These damaged pain nerves will not be able to let you feel the pain for a much longer time. This procedure does not affect the other normal roles of nerves.

The patient is required to lie on the stomach during the procedure.

In this procedure, a probe is inserted. Ultrasound (USG) or fluoroscopic (X-ray) guidance is used to correctly place the cannula. Once done, the radiofrequency ‘radio waves’ are directed through each cannula.

What are the benefits of Radiofrequency Ablation of Ganglion Impar?

• The radiofrequency ablation of ganglion impar has a series of benefits as compared to the other forms of pain relief. Here we list the main benefits:
• The target nerves can be accurately controlled, thus allowing lesioning of small nerves without damaging nearby other nerves.
• Pain relief is rapid and usually side effects are negligible, allo wing the patient to return to normal activity very soon or may be same day.
• Nerve destruction is usually long lasting and heals without any complication..
• The rate of side effects and complications is relatively low.
• When pain recurs, nerve lesion can be repeated as necessary.

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In advanced stage of cancer, if cancer spreads to multiple places and patient has many pain spots; or in few patients, if the above mentioned treatment fails to control the pain; Pain implant is used to treat the pain.