Neuropelveology
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Neuropelveology is a specialised medical domain that focuses on neurological diseases and functional disturbances of the small pelvis.
Neuropelveology also studies direct damage to pelvic nerves that occurs, for example, in multiple sclerosis and spina bifida, as well as traumatic spinal cord lesions and nerve wounds caused by extensive surgery.
Its diagnostic and therapeutic spectrum is very large and includes conditions such as endometriosis, tumours of the small pelvis and postoperative scars and adhesions that may affect the small pelvis nerves and cause pain.
The diagnosis and targeted therapy of pelvic pain and functional disturbances of the small pelvis require specific medical knowledge in gynaecology, urology, neurology and neurosurgery.
Aside from the brain and the spinal cord, no other part of the human body contains such a large number of important nerves as the small pelvis. Not only do pelvic nerves control key motion processes such as standing up, walking and maintaining balance but they also direct vesical and intestinal functions (filling and emptying) and sexual functions.
Signals from the brain to the pelvic nerves travel through the spinal cord and return signals, such as perceptions of pain, are sent back to the brain through the same route.
The nerves, which form a tight nerve bundle within the spinal cord, separate at the level of the small pelvis and innervate different organs, such as the bladder, the intestines and the sexual organs.
Therapy and treatment
Neuropelveology concentrates on three different surgical approaches
Maximum preservation of the pelvic nerves in the case of radical surgery of the small pelvis. The objective is to preserve all sexual, vesical and intestinal functions in interventions such as surgical treatment of endometriosis, myoma hysterectomy or resection of malignant tumours (oncological surgery)
Minimally invasive pelvic nerve laparoscopy to determine the aetiology of pain in the abdomen and pelvic cavity and optimal treatment, including neurosurgical procedures
Electrode implantation on pelvic nerves. This laparoscopic method, which consists in implanting a neuroprothesis, is also called the LION procedure. It is used in the following cases:
Because open surgery does not provide adequate access to the pelvic nerves, all these different treatments only became possible with the advent of laparoscopy in general and pelvic nerve electrostimulation (LANN) in particular. This latter technique makes it possible to identify the function of a nerve during the course of surgery.
The same applies to so-called phantom pain that is produced by the brain when incoming signals are wrongly interpreted as pain emanating from an amputated limb.
The small pelvis is also the only region traversed by the two main nerves of the lower limbs, the sciatic nerve and the femoral nerve, the latter being located at a depth of only a few centimetres.
As a means to control pain in the small pelvis subsequent e.g. to surgical damage of a pelvic nerve or in the case of pudendal nerve pain (pudendal neuralgia), nerve disease (polyneuropathy) in the lower limbs associated with conditions such as diabetes, or phantom pain following amputation.
As a means to restore mobility in paralysed patients (paraplegia, Spina bifida, multiple sclerosis, etc.).
As a means to control and restore vesical, intestinal and sexual functions
The Small Pelvis
Specialist treatments < Neuropelveology
Hirslanden Neuropelveology Centre, Zurich, Switzerland
The Hirslanden Neuropelveology Centre was established under Prof. Marc Possover as a specialist centre within Klinik Hirslanden, part of Switzerland's largest private healthcare group.
Professor Possover has pioneered neuropelveology and is recognised worldwide as a leader in laparoscopic surgery of the nerves located in the small pelvis. The Centre focusses on the integral diagnosis and treatment of pain, diseases and functional disturbances of the small pelvis that have a neurological origin.
Important note to all patients
MHL (Medilux Healthcare Ltd.) promotes individual hospitals or hospital groups which we believe offer high standards of care. We provide you with general information and details of how to make contact with the centre, but we shall not be responsible for the quality of any diagnosis or treatment given or for the failure to diagnose or treat any condition. We cannot advise or enter into correspondence about individual cases and we do not arrange or facilitate treatments.
MHL currently features the following centre for Neuropelveology.
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