Name of the Procedure:

Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve

Summary

A paracervical uterine nerve block is an injection of anesthetic agents and/or steroids around the cervix to block pain signals from the uterus. This procedure is often done to alleviate pain during certain gynecological interventions or to manage chronic pelvic pain.

Purpose

• Medical Condition: Chronic pelvic pain, pain during gynecological procedures.
• Goals: To reduce or eliminate pain from the uterus and surrounding areas, make certain medical procedures more comfortable, and improve the patient’s quality of life.

Indications

• Chronic pelvic pain
• Menstrual cramps (dysmenorrhea)
• Pain during gynecological procedures (e.g., IUD insertion, cervical biopsies)
• Pelvic inflammatory disease
• Endometriosis

Preparation

• Pre-procedure instructions: Fasting or avoiding certain foods/liquids if sedation is planned.
• Medication adjustments: Discuss with your doctor if you are taking blood thinners or other medications.
• Diagnostic tests: Blood tests or imaging studies to rule out other conditions.

Procedure Description

1. The patient lies in a gynecological exam position.
2. The area around the cervix is cleaned with an antiseptic solution.
3. A speculum is inserted to visualize the cervix.
4. An anesthetic agent and/or steroid is then injected into the tissues around the cervix using a thin needle.
5. The needle is carefully guided to ensure accurate placement.
6. The injection takes only a few minutes.

Tools Used: Speculum, sterile needle and syringe, anesthetic agents/steroids, antiseptic solution.

Anesthesia or Sedation: Local anesthesia is typically used; sedation may be offered in some cases.

Duration

The procedure typically takes about 15-30 minutes.

Setting

• Outpatient clinic
• Hospital
• Surgical center

Personnel

• Gynecologist or physician trained in the procedure
• Nurse or medical assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common risks: Mild pain at injection site, minor bleeding, temporary dizziness.
• Rare risks: Infection, allergic reaction, accidental damage to nearby structures.

Benefits

• Significant pain relief during and after the procedure.
• Immediate reduction in discomfort during gynecological procedures.
• Improved quality of life for patients with chronic pelvic pain.

Recovery

• Post-procedure care: Rest for a short period after the procedure, avoid strenuous activities for 24 hours.
• Expected recovery time: Most patients return to normal activities within a day.
• Follow-up: Follow-up appointment as recommended by the physician for assessment and possible additional treatments.

Alternatives

• Oral or intravenous pain medications
• Hormonal treatments (e.g., birth control pills)
• Surgical options (e.g., laparoscopic surgery for endometriosis)
• Physical therapy

Pros and Cons:

• Pros: Minimally invasive, quick relief
• Cons: Temporary effect, may require repeat injections

Patient Experience

• During the procedure: Slight discomfort from the injection, pressure from the speculum.
• After the procedure: Minor cramping or soreness, which typically resolves quickly.
• Pain Management: Over-the-counter pain relievers if needed, local anesthesia ensures minimal pain during the procedure.