Prof. Prof. DK Prof. Dr. med. Marc Possover, MD, PhD

Why Safety Standards Matter in Neuropelveology

The First International Safety & Standards of Care Guidelines in Neuropelveology

The International Society of Neuropelveology (ISON) has published the first international Safety & Standards of Care Guidelines in Neuropelveology, representing an important milestone in the development of this emerging medical discipline.

Neuropelveology is dedicated to the diagnosis and treatment of disorders affecting the pelvic nerves. These disorders may cause chronic pelvic pain, pudendal neuralgia, sacral radiculopathy, bladder dysfunction, bowel dysfunction, sexual dysfunction, gait disturbances, and nerve-related symptoms involving the pelvis and lower limbs.

Unlike many conventional pelvic procedures, neuropelveological surgery directly involves nerves that control sensation, movement, bladder and bowel function, sexual function, and quality of life. For this reason, accurate diagnosis and patient safety are of paramount importance.

Why Were These Guidelines Developed?

In recent years, increasing awareness of pelvic nerve disorders and growing access to advanced laparoscopic and robotic technologies have enabled more surgeons to reach previously inaccessible areas of the pelvis.

However, the ability to surgically expose pelvic nerves does not automatically imply expertise in neuropelveological diagnosis and treatment.

The ISON Safety Guidelines were developed to establish clear international standards regarding:

• Patient safety
• Accurate neuropelveological diagnosis
• Functional nerve preservation
• Surgical indications
• Neurovascular surgical principles
• Training and certification
• Multidisciplinary patient care
• Long-term functional follow-up

The primary objective is simple: to protect patients and promote the highest standards of care.

What Should Patients Know?

One of the most important messages of the guidelines is that neuropelveology is not merely a surgical technique.

A true neuropelveological evaluation requires:

• Detailed analysis of symptoms
• Knowledge of pelvic neuroanatomy
• Understanding of neurological function
• Correlation of symptoms with imaging findings
• Consideration of alternative diagnoses
• Individualized treatment planning

In fact, many patients with pelvic nerve disorders may not require surgery at all. Appropriate diagnosis often allows successful treatment through conservative therapies, targeted infiltrations, physiotherapy, neuromodulation, or other non-surgical approaches.

How Can Patients Identify a Qualified Neuropelveologist?

According to the ISON Guidelines, participation in isolated workshops, webinars, cadaver courses, observational visits, or limited procedural exposure alone is not sufficient to establish independent neuropelveological expertise.

Patients should look for physicians who have:

• Structured training in neuropelveology
• Extensive experience in pelvic nerve diagnosis
• Experience in advanced retroperitoneal pelvic surgery
• Multidisciplinary expertise
• Long-term follow-up of neuropelveological patients
• Documented experience in pelvic nerve disorders and their treatment

The guidelines further emphasize that the professional designation “Neuropelveologist” should ideally be reserved for physicians who have completed advanced structured neuropelveological training pathways and possess documented competence in diagnosis, multidisciplinary management, and independent neuropelveological practice.

A Commitment to Patient Safety

The publication of these guidelines reflects a broader commitment to patient safety, scientific integrity, transparency, and responsible development of neuropelveology worldwide.

As founder of Neuropelveology and Chairman of the International Society of Neuropelveology (ISON), Prof. Marc Possover has long advocated that innovation must always be accompanied by education, competence, and responsibility.

For patients suffering from chronic pelvic pain and pelvic nerve disorders, these guidelines provide an important reference framework and contribute to safer, more standardized, and more transparent care worldwide.

Read the full ISON Safety & Standards of Care Guidelines in Neuropelveology:

DOI: 10.5281/zenodo.20567910

— Prof. Marc Possover

Founder of Neuropelveology

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If you or someone you know is struggling with chronic pelvic pain, pelvic nerve disorders, endometriosis, or consequences of pelvic surgery, please contact us via email at international@possover.com to begin the process. Because we want to avoid the scenario where a patient travels to Zurich, only to discover that we may not be able to offer help for their specific situation, we have Pre-Consultation Zoom process. How does it work?

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