A case of transvaginal lithotripsy for a giant vaginal calculus

Abstract

Introduction: Primary vaginal calculi are relatively rare, compared with secondary calculi. Primary calculi are often a result of urogenital sinus abnormalities, neurogenic bladder, or chronic incontinence.

Case presentation: Forty-seven years old female with cerebral palsy since infancy had longstanding urinary incontinence. She visited her doctor for a fever and was referred to us with a urinary tract infection. Imaging revealed a large vaginal calculus. It was not possible to remove the calculus vaginally without crushing it, so we performed rigid cystoscopy with lithotripsy, using a pneumatic lithotripsy device. The calculus was completely removed without complications.

Conclusion: We were able to remove a large primary vaginal calculus using ultrasonic and pneumatic lithotripsy through a rigid cystoscope. Minimally invasive surgery is a good option for patients with large vaginal calculi.

Keywords: pneumatic lithotripsy device; primary vaginal calculus.

Fig. 1

Abdominal CT shows a calculus in the pelvis, measuring 8.1 × 5.6 × 7.0 cm. The calculus is posterior to the bladder and anterior to the rectum. Cystography shows a stone posterior to the bladder with no evidence of a fistula between the bladder and the vagina.

Fig. 2

The cystoscope was inserted into the vagina and a huge yellowish‐brown calculus was present. The calculus was not adherent to the vaginal mucosa. There was no fistula with the bladder in the vagina.