Giant Vaginal Stone with Embedded Contraceptive Device

Vaginal Calculus Formation on Exposed Midurethral Sling Mesh

“…Secondary stone formation, typically preceded by urine stagnation in the vagina [5,9], is exacerbated due to precipitation on a foreign body. Prior case reports of secondary vaginal calculi, as in the current case, have shown stone formation on vaginal tape mesh [10], an intrauterine contraception device [11], and a pessary [12]. Few previous cases have reported stone formation on mesh [3,9], but exposure of mesh to urine serves as a nidus for stone formation.…”

“…Significant increases in reported adverse events related to vaginal mesh used in gynecological surgeries, including pelvic pain, infection, bleeding, urinary problems, and erosion or perforations, have led the Food and Drug Administration to strengthen requirements for mesh used in surgical cases Case Reports in Obstetrics and Gynecology [13]. For patients with gynecological foreign bodies, followup care and regular exams may helpful in early detection of stones [9,11]. Guidelines from the National Institute of Health and Care Excellence recommend follow-up for patients undergoing gynecological surgeries involving mesh to assess for complications, including indications for vaginal exam to assess mesh patency, exposure, or extrusion [15].…”

Vaginal Urinary Calculi Formation Secondary to Vaginal Mesh Exposure with Urinary Incontinence

“…Reports of primary stones have occurred with urethrovaginal fistulas forming after trauma in association with vaginal stenosis, urinary incontinence secondary to neurologic disorders, ectopic ureters, and urethral diverticula [ 2 , 8 , 9 ]. Secondary stones have been reported primarily in cases of vesicovaginal fistulae with cases involving long-term pessary use [ 10 ], an embedded displaced intrauterine contraceptive device [ 11 ], and retained surgical gauze [ 12 , 13 ]. A report of vaginal stone formation on eroded tension free vaginal tape mesh is also documented [ 14 ].…”

“…The presence of a vaginal stone should be considered if a patient presents with vaginal pain/discomfort, dyspareunia, partner pain with intercourse, dysuria, palpation of mesh/foreign body, or vaginal bleeding or discharge [ 10 , 11 , 14 , 16 , 17 ]. If unable to diagnose a vaginal stone on exam, X-ray imaging should be considered [ 8 ].…”

Secondary Vaginal Stone Around a Forgotten Vaginal Pessary in a Patient with a Vesicovaginal Fistula

“…Primary stones are formed in the vaginal cavity due to the deposition of urinary salts as a result of continuous urinary leakage into the vagina and they have been described in association with urinary leakage caused by vesicovaginal fistulas, urethrovaginal fistulas, an ectopic vaginal ureter and incontinence owing to a neurogenic bladder. A secondary vaginal stone is formed around a foreign body in the vagina such as a vaginal ring pessary, displaced intrauterine contraceptive devices, 11 surgical sutures and other forgotten materials placed in the vagina. Rarely, a vesical calculus may migrate into the vagina because of an ulceration of the vesicovaginal septum and grow in the vagina as a secondary calculus.…”