Intraoperative consultation for gynecologic disorders

A careful history and pelvic examination will allow a more meaningful and thorough preoperative evaluation. It will also greatly reduce the need for subsequent intraoperative consultation for unexpected gynecologic disorders. Medicolegal disasters resulting from unconsented castration or loss of reproductive function may be avoided as well. When unpredictable circumstances are encountered, the urologist should be able to recognize them and know when further expertise is required. In most situations an exact diagnosis can usually be established without sacrificing reproductive or endocrinologic function. Although definitive therapy may need to be delayed and further surgery performed, this is more acceptable in the face of life-threatening disease than the consequences of unnecessary gynecologic surgery or debilitation.