Neuropelveology

The relatively new discipline of Neuropelveology, founded by Dr. Marc Possover, refers to the study of the somatic and visceral innervation of the pelvis and the effects resulting from injury. This field is particularly relevant to endometriosis, pelvic, and sexual health, as the nerves of the pelvis play a significant role in controlling various functions: sexual, urinary, digestive, motion, and sensation. Injuries to these nerves can lead to not only pain but also dysfunction, impacting overall pelvic and sexual health.

Bowel/Bladder Dysfunction

• • Incontinence
  • Spasm
  • Retention

Neuropathic pelvic pain

• • Genital
  • Groin
  • Pudendal
  • Bowel
  • Bladder

Sexual disorders in women and men

The true number of patients suffering from pelvic nerve dysfunction is unknown but almost assuredly underestimated.

How do symptoms correlate to pelvic nerve dysfunction?

Pelvic pain is usually the presenting symptom.  When caused by nerve irritation/compression, there is commonly a predictable distribution or pattern to the pain’s location.

Visceral pain – Nerve fibers in the pelvic organs and supporting tissues transmit pain signals that can be vague and difficult to localize. This type of pain may be accompanied by visceral symptoms such as nausea, fatigue, irritability, bloating, dyspepsia, etc.

Somatic pain – Nerve fibers that transmit movement and sensation signals transmit pain signals that tend to be more specific and more readily reproducible. Somatic pain can be described as a burn, electric shock, and sting.

What is the role of Neuropelveology in Endometriosis Excision Surgery?

Understanding Neuropelveology gives the pelvic surgeon a working knowledge of the anatomy of the pelvic nerves and the corresponding symptoms that arise from irritation or compression of those pelvic nerves.  This helps to direct the surgeon’s excision efforts during surgery.

A physician with specialized training in neuropelveology understands how the visceral and somatic nerves convey information to the spinal cord, the brain, and each other.  With this knowledge, an appropriate care plan can be developed and implemented to relieve pain and restore proper function.