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

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.