Comparative efficacy between fluoroscopy-guided radiofrequency ablation of Superior hypogastric plexus and radiofrequency ablation of Superior hypogastric plexus with Ganglion impar for pelvic pain relief in endometriosis

Abstract

Background:

Pelvic pain of endometriosis often becomes refractory to standard pharmacological methods. For these patients, radiofrequency ablation (RFA) of Superior hypogastric plexus and Ganglion impar are effective alternative.

Aim:

To compare efficacy of RFA of Superior Hypogastric Plexus versus RFA of both Superior hypogastric plexus and Ganglion impar.

Materials and methods:

This parallel group, open-label randomised controlled trial was conducted on 40 women with endometriosis based on particular inclusion and exclusion criteria at a tertiary care hospital. They were divided into two groups using random number table; Group A received RFA of Superior hypogastric plexus and Group B received RFA of Superior hypogastric plexus with Ganglion impar. Our study parameters were Visual Analogue Scale (VAS) for pain and short-form Endometriosis Health Profile (EHP-5) for quality of life. Data was taken at baseline, at 24 h, 1 week, 4 weeks and 12 weeks.

Results:

Significant (p < 0.05) improvement was noted in VAS and EHP-5 score in individual groups at all intervals. Group B has shown a better outcome of both parameters on all the follow-ups, but significant differences were noted at 24 h in the VAS score (p = 0.025) and at 1 week in the EHP-5 score (p = 0.040).

Conclusion:

Both groups have shown significant improvement compared to baseline. However, significant improvement was noted in both the parameters on short term when Ganglion Impar is ablated along-with Superior Hypogastric Plexus.