Pelvic IOM (PIOM) and Bladder Pressure Monitoring are techniques used during surgeries in the lower spinal cord, sacrum, and pelvic area to protect neural functions related to urinary and sexual health. These methods, including measuring bladder pressure and monitoring neural pathways with SSEPs, MEPs, and EMG, provide real-time feedback on nerve integrity. Essential for surgeries at risk of affecting bladder, bowel, and sexual function, these monitoring techniques enable surgeons to minimise nerve damage, preserving postoperative quality of life.