Huge Primary Vaginal Stone in a Recumbent Woman

Abstract

Summary Objective Vaginal stones are rare and primary vaginal stones are extremely rare. A primary vaginal stone originating from urinary stasis in the vagina may be due to anatomic abnormalities, vaginal outlet obstruction, infection, or vesicovaginal fistulae, while secondary vaginal stones result from crystallization of urinary constituents around a foreign body in the vagina. Case Report This 43-year-old female had cerebral palsy due to tuberculosis meningitis when she was 3 years old. She had been bedridden with urinary and fecal incontinence since then. She was admitted to our medical ward due to acute abdominal distension with poor appetite and weight loss. On arrival, leukocytosis with dehydration was noted and medical treatment was given initially. Imaging studies showed stool impaction with abdominal ileus and a huge calcified density measuring 10 cm in diameter in the pelvis. Exploratory laparotomy showed that the mass was in the vagina. A laminated and pear-shaped mass was removed through an incision in the anterior vaginal cuff. Pathologic examination showed lithiasis composed of calcification mixed with fibrinous exudates and fragments of reactive squamous epithelium. The postoperative course was smooth with uneventful convalescence and she was discharged and doing well at the time of writing. Conclusion Although vaginal stones are very rare, they may be formed in recumbent women due to urinary stasis, and the calculi may cause obstruction of the bowel or urinary tract.