Colpolithiasis: A mini review

Abstract

Objective: Vaginal calculus is an unusual finding. In this study we describe a case of primary vaginal calculus in a rather rare urogenital anomaly- Obstructed hemivagina with ipsilateral renal agenesis (OHVIRA) syndrome. This syndrome is shrouded in controversies. Here we present a mini review about vaginal calculus and theory of embryological development of female genital tract as related to OHVIRA syndrome. Case: A 50 years-old unmarried lady with primary amenorrhoea presented with pain abdomen. She was found to have calculus in the pelvis by x-ray which was thought to be bladder calculus initially. On local examination the vaginal opening was absent. Imaging studies such as NCCT and MRI confirmed that it is a vaginal calculus, located below the uterine cervix, with absent right kidney. She was diagnosed with OHVIRA syndrome with colpolithiasis. On laparotomy she was detected to have unicornuate uterus with absence of right Mullerian structures. The calculus occupied the whole of upper part of vagina, which was a blind pouch. The patient underwent total abdominal hysterectomy, left salpingo-ophorectomy with removal of calculus after opening the vaginal vault. Postoperative recovery was uneventful. Chemical analysis of the calculus revealed calcium magnesium oxalate which is of hematic origin. Keywords: Primary vaginal calculus, Mullerian duct anomaly, Obstructed hemivagina, OHVIRA syndrome, Herlyn-Werner-Wunderlich syndrome.