Superior hypogastric plexus versus ganglion impar block for pelvic and perineal pain in cervical or endometrial cancer
Hypogastric Plexus Block and Ganglion Impar Block for Cervical and Endometrial Cancer Pain Management: A Randomized Controlled Trial of Efficacy and Safety
This trial tests whether a superior hypogastric plexus block or a ganglion impar block better reduces pelvic and perineal pain in adults with cervical or endometrial cancer who haven't gotten enough relief from medications.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 36 (estimated) |
| Ages | 18 Years and up |
| Sex | Female |
| Sponsor | University of Brawijaya Academic / other |
| Locations | 1 site (Malang, East Java) |
| Trial ID | NCT05427058 on ClinicalTrials.gov |
What this trial studies
This interventional comparison enrolled adults with cervical or endometrial cancer and persistent pelvic or perineal pain despite WHO ladder therapy. One group received a superior hypogastric plexus block via a transdiscal L5–S1 approach with 5 ml 1% lidocaine followed by 10 ml 96% alcohol, and the other group received a ganglion impar block via a trans‑sacrococcygeal approach with 4 ml 1% lidocaine followed by 6 ml 96% alcohol, both confirmed under C‑arm fluoroscopy. Pain intensity and safety outcomes were recorded before and after the procedures and during follow‑up visits. The aim was to compare analgesic effectiveness and procedure‑related complications between the two techniques at a single center in Malang, East Java.
Who should consider this trial
Good fit: Adults (over 18) with cervical or endometrial cancer who have pelvic or perineal pain rated >4 on the numeric scale and who have not obtained adequate relief from or cannot tolerate WHO ladder medications are the best candidates.
Not a fit: Patients with bleeding or clotting disorders, local infection at the injection site, those taking anticoagulants, or those whose pain is not originating from the pelvic floor/perineum are unlikely to benefit or are ineligible.
Why it matters
Potential benefit: If successful, one procedure could offer more durable pelvic/perineal pain relief, reduce opioid use and its side effects, and improve quality of life for affected patients.
How similar studies have performed: Both superior hypogastric plexus and ganglion impar blocks have been reported to relieve cancer-related pelvic and perineal pain in case series and small studies, but direct head‑to‑head comparative data are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Unbearable cancer pain that is resistant to WHO (World Health Organization) pain ladder at least 2 weeks medication * The patient is tired of taking medication orally or complications of current medication (respiratory depression, nausea, vomiting, opioid-induced constipation, gastrointestinal disturbances) * Patients with pelvic floor pain diagnosed by a (Fellow of Interventional Pain Practice) FIPP-certified pain specialist * Patients with pain in the perineum diagnosed by a FIPP-certified pain specialist * Numerical Rating Scale \>4 * \>18 years old * Able and willing to sign an informed consent Exclusion Criteria: * Refuse to be included in the research * Blood clotting disorders (including taking anticoagulant drugs) * Local infection in the area of action * Loss to follow up Drop-out Criteria: * Loss to follow up * Intervention complications occur * Failed intervention
Where this trial is running
Malang, East Java
- General Hospital Saiful Anwar Malang — Malang, East Java, Indonesia (Recruiting)
Study contacts
- Principal investigator: Ristiawan M Laksono — Brawijaya University
- Study coordinator: Ristiawan M Laksono, MD,FIPP
- Email: ristiawanm@ub.ac.id
- Phone: +6281233773593
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.