Transsacrococcygeal neurolytic block of ganglion impar in vulvar carcinoma: a case report

Abstract

Introduction:  Ganglion impar block is used to overcome chronic perineal pain problem. The ganglion block has been used to treat perineal pain or severe perianal pain. This case report presents the success of ganglion impar blocks in a patient with vulvar cancer experiencing chronic pain which failed to respond to pharmacotherapy. We used alcohol for chemical neuolysis of ganglion impar through transsacrococygeal route. The pain scores decreased significantly and there were no complications. We conclude that the ganglion impar block is an effective therapy for perineal pain management in patients with malignant vulvar cancer, and can be used with other treatment modalities including pharmacotherapy, psychological counseling and physical therapy to optimize the management in this group of patients.