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Review
. 2020 Oct 30;13(10):e235103.
doi: 10.1136/bcr-2020-235103.

Large primary vaginal stone in a woman with multiple sclerosis

S Lot Aronson  1 , Marina C Hovius  2 , Erica W M Janszen  3
Affiliations
Review

Large primary vaginal stone in a woman with multiple sclerosis

S Lot Aronson et al. BMJ Case Rep. .

Abstract

Vaginal stones are rare and therefore a delay in accurate diagnosis often occurs. We present a 54-year old woman with multiple sclerosis who was diagnosed with a primary vaginal stone. Initially, she presented with recurring urinary tract infections (UTI) and macroscopic haematuria to the urologist. A cystoscopy showed no abnormalities. Because of persistent bleeding, she was referred to the gynaecologist, and on gynaecological examination, a vaginal stone was revealed. Stone formation was likely to be the result of urinary pooling due to incontinence, which was caused by a neurogenic bladder. Other contributing factors were prolonged recumbency, threads of an intrauterine device and a UTI. The presence of a vesicovaginal fistula was excluded by testing with methylene blue. The stone was surgically removed and composed of 70% struvite and 30% apatite. The patient was treated for decubitus ulcerations of the vaginal wall with estriol (Synapause-E3). Follow-up was uneventful.

Keywords: obstetrics and gynaecology; urology; vulvovaginal disorders.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Primary vaginal stone on examination.
See this image and copyright information in PMC

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