Clinical outcomes of combined ganglion impar block and caudal epidural steroid injection in chronic perineal pain: a retrospective study

Year 2026, Volume: 7 Issue: 2, 323 - 329, 27.03.2026

Gözde Çelik , Fatemeh Farham , Çile Aktan , Nurten İnan

https://izlik.org/JA52MX65FN

Abstract

Aims: Chronic perineal pain is a complex and debilitating condition that often shows limited response to conservative treatment modalities. Ganglion impar block (GIB) and caudal epidural steroid injection (CESI) are established interventional techniques; however, clinical data on their combined use are limited. This study aimed to evaluate the effectiveness and safety of performing GIB and CESI concurrently in patients with chronic perineal pain.
Methods: This retrospective study included 43 patients who underwent combined GIB and CESI in a single session. Demographic and clinical data were obtained from medical records. Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline, 3 weeks, and 6 months after the procedure. Adverse events and the need for repeat interventions were also evaluated.
Results: The study population consisted predominantly of female patients (81.4%), with a mean age of 41.79±14.10 years. Trauma was the most common pain etiology (62.8%). Median VAS scores decreased significantly from 8 [6–10] at baseline to 0 [0–8] at 3 weeks and to 2 [0–8] at 6 months (p<0.0001). Repeat procedures were required in 18.6% of patients. Procedure related adverse events were mild and transient, consisting mainly of paresthesia (7.0%) and peripheral edema (2.3%), with no major complications reported.
Conclusion: Combined application of GIB and CESI appears to be a safe and effective interventional option for patients with chronic perineal pain, providing clinically meaningful pain relief in the short and mid-term.

Keywords

Ganglion impar block , caudal epidural steroid injection , chronic perineal pain , interventional pain management

Ethical Statement

This study was conducted by the Declaration of Helsinki and approved by the Malatya Turgut Ozal University Ethics Committee approval number (MTÜKAEK no: 2025/32, Application no: 2025000032-2).

Supporting Institution

This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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