Urologic injury during pelvic surgery is primarily a matter of prevention; should it occur, however, prompt recognition and appropriate management are essential. Basic principles are applicable, whether the operation has been performed via the abdominal or the vaginal route. Conditions such as endometriosis, infection, previous operation, and tumor distortion increase the likelihood of damage to the urinary tract. Difficult dissection may easily damage the urethra, bladder, or ureters. Preliminary information as to the position of the ureters and bladder will alert the surgeon. Exacting identification of the ureter and bladder is necessary prior to the use of clamps, sutures, or incision. The next most important factor is recognition of such injury. Whenever the possibility exists, it must be promptly and definitively delineated. Injury to the urethra, bladder, or ureters, when recognized and appropriately repaired, is unlikely to cause subsequent complications. Good surgical techniques, adequate and accurate hemostasis, prevention or treatment of infection, drainage of the operative site, and splinting and resting of the organ are necessary. It is the unrecognized and unrepaired urologic injury that increases the chances of immediate and delayed complications. Peritonitis, infection, stricture, fistula, hydronephrosis, and renal damage as well as death may occur even if the patient survives the immediate postoperative complications. It is important in such instances that the error not be compounded by rash attempts at additional surgical procedures at an operative site where there is maximal tissue reaction. General supportive measures with drainage of the urinary tract to preserve renal function are all that should be done. It is likewise important that the surgeon not be rushed into an early attempt to correct the resultant fistula. Adequate time must be allowed for the tissues to heal so that the subsequent repair may be carried out successfully and without further complications.
盆腔手术期间的泌尿外科损伤主要在于预防；然而，如果发生损伤，迅速识别和恰当处理至关重要。无论手术是经腹部还是经阴道途径进行，基本原则都是适用的。诸如子宫内膜异位症、感染、既往手术史和肿瘤变形等情况会增加尿路受损的可能性。困难的解剖操作可能很容易损伤尿道、膀胱或输尿管。关于输尿管和膀胱位置的初步信息会提醒外科医生。在使用夹子、缝线或进行切口之前，必须准确识别输尿管和膀胱。接下来最重要的因素是识别此类损伤。只要有可能，就必须迅速且明确地确定损伤情况。尿道、膀胱或输尿管损伤一旦被识别并得到恰当修复，不太可能引发后续并发症。良好的手术技巧、充分且准确的止血、感染的预防或治疗、手术部位的引流以及器官的固定和休息都是必要的。未被识别和未修复的泌尿外科损伤会增加即刻和延迟并发症的发生几率。即使患者在术后即刻并发症中存活下来，也可能发生腹膜炎、感染、狭窄、瘘管、肾积水、肾损伤甚至死亡。在这种情况下，重要的是不要在组织反应最大的手术部位因轻率尝试额外的手术操作而使错误更加严重。应该采取的措施只是通过尿路引流来维持肾功能的一般支持性措施。同样重要的是，外科医生不应急于过早尝试纠正由此产生的瘘管。必须留出足够的时间让组织愈合，以便后续修复能够成功进行且不出现进一步并发症。
