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