Aim of the study: To estimate the efficacy and safety of the neurolytic block of the ganglion impar (sympathetic) in reducing intractable perineal pain of pelvic cancer through sacrococcygeal approach.

Methods: Forty patients were studied. The mean age was 49.7 years (rang 35-58). They had been pelvic cancer with sever perineal pain not relieved with conventional therapy. All the patients were submitted to neurolytic blocks of ganglion impar with 4 ml of 70٪ alcohol. The pain was evaluated with VAS score: previous to the blockade, 2h later, 24 hours later, 7 days, and one month.

Results: All blocks were easy to perform and were confirmed by C-arm without recorded complications. A highly significant reduction (P value <0.01) in VAS score 2 hours, and 24 hours after the blocks and significant reduction (P value <0.05) in VAS score at 7 days and one month.

Conclusion: The neurolytic blocks of ganglion impar in intractable perineal pain of pelvic cancer through sacrococcygeal approach is effective in relieving perineal pain.