Primary Vaginal Calculus in a Woman with Disability: Case Report and Literature Review

Abstract

Background: Vaginal stones are rare and often unknown entities. Most urologists may never see a case in their careers. Case Presentation: We present the case of a 34-year-old bedridden Caucasian woman with mental and physical disabilities who presented with a large primary vaginal calculus, which, surprisingly, had remained undiagnosed until the patient suffered a right renal colic caused by a ureteral stone. The vagina was completely filled and a digital examination was not possible. For this reason, the stone was removed using surgical pliers with some maneuvering. A vesicovaginal fistula was excluded, as well as foreign bodies or other nidi of infection. After, urethral lithotripsy was performed as planned. The postoperative course and follow-up were uneventful. Conclusion: Although vaginal calculi are extremely rare in literature, their differential diagnosis should be considered in women with incontinence and associated disabilities, paraplegia, or prolonged immobilization in recumbent position.

Keywords: disability; paraplegia; primary calculus; urinary incontinence; vaginal calculus.

FIG. 1.

Rx fluoroscopy imaging of the vaginal calculus during the urethral catheterization.

FIG. 2.

Vaginal calculus is seen through hymenal orifice in the vagina during its removal.

FIG. 3.

The large round hard vaginal stone (∼5.1 × 3.7 × 3.1 cm) removed from the vagina.