Case report: Tenesmus and the role of superior hypogastric plexus blocks

Abstract

Background:

Tenesmus is the unpleasant sensation of incomplete emptying of the rectum and it may be a distressing symptom for patients who suffer from rectal masses. Unlike nociceptive pain or visceral pain, little is understood about the pathway for this pain phenotype. There are also few studies examining the palliative treatment of this symptom.

Case Presentation:

In this case report, we describe a patient who presented with severe and refractory tenesmus secondary to a metastatic rectal lesion.

Case Management:

To address the patient’s refractory tenesmus, a superior hypogastric plexus neurolytic block was performed with alcohol under fluoroscopic guidance.

Case Outcome:

Immediately after the procedure, the patient reported complete abolishment of her tenesmus symptom. This effect endured for 3 months after which the patient.

Conclusion:

Superior hypogastric plexus block may be an effective procedure for the management of tenesmus. The successful abolishment of tenesmus following the block alludes that the nerve fibers carrying sensation of tenesmus either synapses or passes through the superior hypogastric plexus. Future studies should consider examining the neural pathway of tenesmus.