Korean J Pain.  2010 Mar;23(1):65-69.

Ganglion Impar Block With Botulinum Toxin Type A for Chronic Perineal Pain -A Case Report-

• Lim SJ
• Park HJ
• Lee SH
• Moon DE

Abstract

Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.

Keyword

botulinum toxin type A; ganglion impar

MeSH Terms

Botulinum Toxins
Botulinum Toxins, Type A
Frustration
Ganglion Cysts
Humans
Muscle Relaxation
Nerve Block
Neurotransmitter Agents
Pain Perception
Urinary Bladder
Botulinum Toxins
Botulinum Toxins, Type A
Neurotransmitter Agents

Figure

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  Fig. 1 Lateral view of the ganglion impar after contrast injection.

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  Fig. 2 AP view of the ganglion impar after contrast injection.

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