Injury to the ureter and bladder are relatively rare occurrences and provoke significant diagnostic dilemmas. Etiologies include external trauma, such as automobile accidents or gunshot wounds, and iatrogenic injuries during pelvic surgery or endoscopy. When lower urinary tract injury goes unrecognized, presenting symptoms can be vague and often delay diagnosis. Such delays may result in prolonged hospital stays and deterioration of renal function and have significant impact on a patient's quality of life. Reconstruction of these injuries can be challenging depending on the mechanism and location of injury. Overall functional outcomes of reconstruction for ureteral or bladder injuries is excellent, but there is limited data on post-operative voiding function. One unique injury worth mentioning is mesh erosion into the genitourinary tract where patients may have persistent lower urinary tract symptoms after reconstruction.