Vaginal Stone Research Articles

Minimally Invasive Management of Massive Vaginal Stone Related to Vesicovaginal Fistula Using Nephroscope and Lithoclast

Minimally Invasive Management of Massive Vaginal Stone Related to Vesicovaginal Fistula Using Nephroscope and Lithoclast

Multiple vaginal stones secondary to an ectopic ureter in an adult female patient: a case report

Vaginal stone is a rare case with low incidence. Ectopic ureter insertion into the vagina is one of the congenital abnormalities that may lead to vaginal stone formation. True incontinence persisting until adulthood might indicate an ectopic ureter, often associated with a complete duplex renal system. We reported an adult female that came with a chief complaint of true incontinence since she was young. However, it was left untreated due to limited healthcare facilities in her area and low socioeconomic status. The computed tomography examination revealed a right complete duplex renal system, with upper moiety inserted into the vagina, and multiple vaginal stones. Thus, stone removal and ureteroneocystostomy procedure were performed. No further complaints or complications were recorded after the hospital discharge.

Vaginal stone formation around intrauterine device in an ambulatory woman with morbid obesity

No Abstract

Vesicovaginal fistula with bladder and vaginal stone.

IntroductionIn developing countries, Vesico-vaginal fistula (VVF) results following obstetric trauma or iatrogenic during hysterectomy. Large calculus associated with VVF is relatively rare, with the risk factor are presence of foreign body, urinary tract infection, and prolonged duration of disease. Most bladder stones can be found among patients who are bedridden, indwelling urethral catheter, bladder outlet obstruction, infection, and other similar characteristic. We report a case of VVF with bladder and vaginal stone in 37 years old woman and reviews the evaluation and treatment and highlights the role of the healthcare team in managing patients with this condition.Presentation of caseA 37-year-old, P2A0, woman with a history of hysterectomy three years ago. Intermittent small amounts of watery vaginal discharge developed 1,5 years after the operation. A physical examination revealed mild tenderness over the suprapubic area and no evidence of uterine prolapse. Cystography computed tomography scan with contrast confirmed a fistula vesicovagina with a connection between posterosuperior wall of vesica urinaria and anterosuperior wall of vagina with vesicolithiasis, size 15 × 26 × 14 mm and two vaginal stone with size of 7 × 12 × 17 mm and 4 × 4 × 5 mm. Cystoscopy revealed a grayish stone identified in supratrigone with size of 30 × 12 mm.DiscussionA hanging intravesical stone on the dome of urinary bladder is scarce, possibly caused by any synthetic and non-absorbable suture material inside of the bladder were encrusted forming a bladder stone. Important risk factors known, which is specific in developing countries, are poor socioeconomic status, malnourishment, low literacy rate, early marriage and childbearing, and inadequate obstetrical care.ConclusionAlthough the incidence of VVF accompanied by hanging vaginal stone and a large bladder stone is scarce, reports of any case regarding this study can be beneficial to other studies. Due to its harmful effect, the usage of non-absorbable sutures material during surgery isn't suggested. Hence, the absorbable suture material usage with careful dissection is suggested for any gynecological or pelvic surgery.

A huge vaginal stone in a spastic paraplegic woman.

A huge vaginal stone in a spastic paraplegic woman.

Huge primary vaginal stone protruding through vaginal orifice damaging the hymen and associated with vesicovaginal fistula and urinary bladder stone: Case Report

Background: vaginal stone (VS) is a rare condition with non-specific presentation, different predisposing factors and can affect different age groups. Its diagnosis is usually incidental and needs high index of suspicion. Case summary: we reported a case of 29 years old single lady presented with continuous urine leak for more than one year. Ultrasound study (USS) showed urinary bladder (UB) stone. Gynecological examination revealed huge VS damaging the hymen as it extended distal to the level of hymen, cystoscopy showed big UB stone and vesicovaginal fistula (VVF). VS extracted, UB stone removed by open vesicolithotomy (VL) and VVF was planned to be repaired after three months. To our knowledge this is the first VS that compromise the intactness of the hymen. Conclusion: This case demonstrate primary VS due to VVF associated with UB stone causing hymen damage. Key Words: Vaginal stone, urinary bladder stone, vesicovaginal fistula, hymen. Abbreviations: VS; vaginal stone. USS; ultrasound study. UB; urinary bladder. VVF; vesicovaginal fistula. VL; vesicolithotomy. CT; computed tomography. MRI; magnetic resonance imaging.

Surgical treatment for huge vaginal stone secondary to vaginal mesh exposure with stress urinary incontinence

Surgical treatment for huge vaginal stone secondary to vaginal mesh exposure with stress urinary incontinence

A rare case of vaginolith, vesical calculus with vesicovaginal fistula in adolescent female

A case of large dumbbell shaped stone involving both vagina and urinary bladder secondary to vesicovaginal fistulae is presented. Vagina is a rare site for urinary stone formation. Clinical presentation is variable like difficulty in micturation and dyspareunia. Proper vaginal examination can be helpful to make the diagnosis. Attention is paid especially in young gynecologists for the importance of 1 st doing pelvic examination before carrying certain investigations and have a possibility of VVF with vaginal stone. We present a neglected case of vesicovaginal fistula with vaginolith and vesical calculus formation in a 15 year old girl with continuous dribbling of urine per vagina. Diagnosis was confirmed on ultrasonography CT IVU demonstrating exact site and size of vesical calculus. Vesical calculus was removed by combined suprapubic approach and repair of fistula was done after interval of 6 months by suturing urinary bladder and vagina defect and omentum interposition in between them.

Large Vaginal and Bladder Calculi in a Woman With Previous Operation of Bladder Exstrophy: A Case Report

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones.

A Large Primary Vaginal Calculus in a Woman With Paraplegia

The study aimed to report a primary vaginal stone, an extremely rare entity, without vesicovaginal fistula in a woman with disability. We describe the case of a large primary vaginal calculus in a 22-year-old woman with paraplegia, which, surprisingly, was not diagnosed until she was examined under general anesthesia during a preparation for laparoscopy for an adnexal mass. The stone had not been identified by physical examination with the patient in a recumbent position or by transabdominal ultrasonography and pelvic tomography during the preoperative preparation. Vaginoscopy was not performed because the vagina was completely filled with the mass. As a result of its size and hard consistency, a right-sided episiotomy was performed and a 136-g stone was removed using ring forceps. A vesicovaginal fistula was excluded. There was no evidence of a foreign body or other nidus on the cut section of the stone, and it was determined to be composed of 100% struvite (ammonium magnesium phosphate). Culture of urine obtained via catheter showed Escherichia coli. After the surgical removal of the calculus without complications, a program of intermittent catheterization was started. The follow-up period was uneventful, and the patient was symptom free at 6 months after the operation. We postulate that the calculus formed as a consequence of urinary contamination of the vagina in association with incontinence and prolonged maintenance in a recumbent posture. This report is important because it highlights that, although vaginal stones are very rare, their possibility should be considered in the differential diagnosis of individuals with long-term paraplegia.

CASE REPORT Primary vaginal stone in a disabled child

CASE REPORT Primary vaginal stone in a disabled child

Primary vaginal calculus secondary to urethrovaginal fistula with imperforate hymen in a 6-year-old girl

Primary vaginal stones are extremely rare in children and may be mistaken for bladder calculi on plain radiography. We present a case of a large vaginal calculus in a 6-year-old girl who had an imperforate hymen and urethrovaginal fistula. Hymenotomy and urethrovaginal fistula repair were performed, and the vaginal stone was extracted. It was postulated that the vaginal calculus originated from stasis of urine through the urethrovaginal fistula in the obstructed vagina. This is a unique case of a vaginal calculus with a congenital urethrovaginal fistula associated with an imperforate hymen.

Primary Vaginal Stone in a Young Active Woman

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

Huge Primary Vaginal Stone in a Recumbent Woman

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.

Vesical Calculi With Unrepaired Vesicovaginal Fistula: A Clinical Appraisal of an Uncommon Association

Primary vesical calculi are uncommon in patients with vesicovaginal fistula (VVF). We retrospectively analyzed 19 such cases and present our experience with the management of this condition. Between January 1989 and December 2002, 19 patients were treated for this association. All patients provided a history and underwent physical examination, metabolic evaluation for stone disease, urine culture test and cystovaginoscopic examination. They were treated with a staged procedure with the fistula repaired 2 to 3 months after stone removal. VVF was a result of obstructed labor in all cases. The patients presented a mean of 28.8 months after fistula formation. No metabolic abnormality was detected in any patient. Urine culture was positive for Proteus mirabilis in 6 and Escherichia coli in 5, and it yielded mixed growth in 8. All women had some residual urine in the bladder (mean 11 ml). The fistula was located supratrigonally in 13 cases, while it was high trigonal in the remainder. A total of 17 patients were treated endoscopically by cystolitholapexy or fragmentation of the stone by transurethral cystolithotripsy using a Lithoclast (Microvasive Urology, Natick, Massachusetts). Two patients required open suprapubic cystolithotomy. All patients underwent fistula repair 3 months after stone removal with successful results in 16. Primary vesical calculi in patients with VVF are associated with urinary contamination, a high or supratrigonal fistula location, residual urine in the bladder and a long history of disease. Staged management of the problem showed good results.

A Primary Vaginal Stone in a Disabled Child

In Brief BACKGROUND Primary vaginal stones in children are extremely rare but important because they are often mistaken for bladder calculi on plain film. CASE A 13-year-old girl was admitted to the hospital with abdominal pain. Physical and serial radiologic examinations found a hard mass anterior to the rectum. By vaginoscopy, the stone was found at the posterior fornix of the vagina. CONCLUSION Primary vaginal stones should be suspected, especially in disabled children. Presence of a vaginal stone indicates the possibility of a urinary-vaginal fistula, an ectopic vaginal ureter, or a neurogenic bladder with urinary incontinence.

A primary vaginal stone in a disabled child

BACKGROUND: Primary vaginal stones in children are extremely rare but important because they are often mistaken for bladder calculi on plain film. CASE: A 13-year-old girl was admitted to the hospital with abdominal pain. Physical and serial radiologic examinations found a hard mass anterior to the rectum. By vaginoscopy, the stone was found at the posterior fornix of the vagina. CONCLUSION: Primary vaginal stones should be suspected, especially in disabled children.

Litiasis vaginal primaria asociada a fístula uretrovaginal. Presentación de un caso y revisión de la literatura

AbstractVaginal stones are rare. We can classify them as primary or secondary, depending on the presence or the abscense of a foreign body nidus. Various cases can led to stone formation. Most of them developed in women with a vesicovaginal or urethrovaginal fistula, as well as in patients with congenital anomalies of the genitourinary tract, previous pelvic radiotherapy, neuropathic bladder and other different causes of vaginal outlet obstruction. Secondary vaginal stones, formed around foreign bodies, are not so frequentRadiological examination and urethro-vaginoscopy make easy the right diagnosis. Sometimes the stone may be fragmented by lithotripsy before the extraction. The associated etiology should be treated concomitantly in order to prevent recurrenceWe report a case of primary vaginal stone associated with an urethrovaginal fistula in a 25 years old women and a review of the related literature

Großer Vaginalstein bei einer Patientin mit multipler Sklerose

Bei einer 42jährigen Frau, die seit über 20 jahren an einer Harninkontinenz infolge multipler Sklerose litt, war es zur Bildung eines 1 kg schweren Steins in der Vagina gekommen. Aufgrund einer Drucknekrose bildete sich eine große vesico-vaginale Fistel. Das Konkrement wurde im Rahmen einer Laparotomie entfernt, gleichzeitig erfolgte die Anlage eines lleumconduits.

A CASE OF PANPERITONITIS DUE TO PERFORATED PYOMATED PYOMETRA WITH VAGINAL STONES

Both perforated pyometra and vaginal stone are very rare entities. We experienced a case of panperitonitis due to perforated pyometra with vaginal stones. An 82-year-old woman who was staying at the hospital for hemiparalysis after cerebral infarction had a sudden onset of severe abdominal pain with tenderness, high fever (38.5°C), vomiting and diarrhea. Abdominal X-ray examination revealed paralytic ileus. Emergency laparotomy was performed under a diagnosis of panperitonitis, and purulent ascites and perforated uterus were revealed. Perforated site was sutured insted of hysterectomy, because the uterine wall remained no serious inflammation. At drainage of the uterine cavity, 6 pieces of vaginal stone were found. Postoperative pathological study reveled no malignancy in her uterus and postoperative course was smooth uneventiful. E. coli and Proteus mirabilis were detected from the purulent ascites. Pyometra is commonly found in aged population, but perforated pyometra is rare. So far 39 cases of perforated pyometra have been reported in the Japanese literature. As to vaginal stone, there have been only 15 cases in our review.