Primary Vaginal Stone in a Young Active Woman

Abstract

Vaginal stones are rare. Most gynecologists may never see a vaginal stone case throughout their career. The earliest reported case was in 1900, in which a stone formed in a vaginal cystocele [1]. Most vaginal stones are derived from the deposition of urinary salt. Stones consisting of phleboliths in the venous plexus of the vaginal wall [1] and primary vaginal calculus of hematic origin in an unmarried woman with a congenital vaginal septum [2] were reported. They were classified as primary and secondary stones. Primary vaginal stones are believed to originate from the stasis of urine in the vagina without an obvious nidus, whereas secondary vaginal stones are the result of crystallization of urinary constituents around a foreign body in the vagina [3]. A 24-year-old unmarried woman visited our gynecologic clinic because of dyspareunia. She had undergone surgery for imperforate anus shortly after her birth, and she had regular menstruation during her adolescence. Pelvic examination found a transverse vaginal septum at the middle portion of the vagina with a central perforation of approximately 1 cm in diameter. Her urethra opening was about 1 cm below the usual site. It became part of the vagina, close to the vaginal orifice. This condition is so called hypospadias in female patients. Magnetic resonance imaging showed a double uterus, bilateral hydrosalpinx, and two vaginal stones in the upper part of the vagina (Figures 1 and 2). The perforated hole on the transverse vaginal septum was dilated using a Hegar dilator and finger. Two smooth surfaced, darkish stones with offensive odor measuring 4 × 3 × 1 cm and 2.1 × 0.8 × 0.4 cm were found behind the septum and were removed using ring forceps (Figure 3). Stone analysis was performed at the