Management of cyclical pelvic pain by multiple ultrasound-guided superior hypogastric plexus blocks in a rare case of Mayer- Rokitansky-Küster-Hauser syndrome - A case series of three blocks in a patient

Abstract

Mayer-Rokitansky-Küster-Hauser syndrome is an uncommon disorder of mullerian agenesis where patients face multiple challenges like difficulty or inability to conceive and have sexual intercourse and chronic abdominal pain. This is a case report of a patient with Mayer-Rokitansky-Küster-Hauser syndrome who presented to the pain clinic with severe cyclical pelvic pain unresponsive to conservative treatment. This case was successfully managed with three ultrasound-guided superior hypogastric plexus blocks. This case illustrates that acute pelvic pain in MKRS patients can be effectively treated with bedside ultrasound-guided superior hypogastric plexus blocks. However, a GnRh analogue or hysterectomy is recommended for definitive treatment.

Keywords: Mayer-Rokitansky-Kuster-Hauser syndrome; Superior hypogastric plexus block; pelvic pain; ultrasound.