Neuropelveology: The missing competency in Pelvic Surgery

Disorders of the pelvic nervous system remain among the least recognized disorders in modern clinical practice. Their complex clinical presentation frequently spans gynecology, urology, neurology, colorectal surgery, pain medicine, and rehabilitation, resulting in delayed diagnosis, fragmented care, and repeated ineffective interventions.

Neuropelveology has emerged as a multidisciplinary competence integrating neurofunctional diagnosis, pelvic neuroanatomy, minimally invasive pelvic nerve surgery, imaging, neurophysiology, and functional rehabilitation. This article discusses the clinical and educational gap that led to its development and explains why pelvic nerve disorders cannot be adequately addressed within the traditional boundaries of existing medical specialties. The expanding role of laparoscopic and robotic surgery has increased access to pelvic neural structures while simultaneously emphasizing the need for standardized diagnostic pathways, competency-based training, patient safety principles, and multidisciplinary collaboration. The discipline is further supported by the recent development of international guidelines, structured educational pathways, certification programs, and collaborative scientific initiatives led by the International Society of Neuropelveology (ISON), providing the foundation for harmonized clinical practice and education.

Rather than representing a new surgical specialty, Neuropelveology provides a comprehensive multidisciplinary framework for the diagnosis, treatment, education, and scientific development of pelvic nerve disorders. As pelvic neuromodulation, restorative neurotechnology, and bioelectronic medicine continue to evolve, Neuropelveology represents an essential step toward safer, neurofunctionally oriented, and more integrated pelvic care.