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

Shailaja, Chhetri; Dhurba, Uperty; Subedi, Shanti; Bajracharya, Junu

doi:10.5005/jp-journals-10006-1031

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…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.…”

Section: Discussionmentioning

confidence: 49%

Vaginal Calculus Formation on Exposed Midurethral Sling Mesh

Langer,

Saeed,

Barrett

et al. 2024

Case Reports in Obstetrics and Gynecology

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The presence of a vaginal calculus is a rare clinical entity which may develop in the setting of vaginal urinary stagnation. Numerous factors contribute to stone formation, and management can be complicated by variations in size, location of the stone, and location of adjacent structures. Generally, once diagnosed, vaginal calculi should be removed and surrounding anatomy should be evaluated thoroughly for secondary fistula, erosion, or presence of an instituting foreign body. This report presents a case of vaginal calculus formation on exposed midurethral sling mesh in an elderly patient with hemorrhagic cystitis. This report emphasizes contributing pathophysiology, diagnostic factors, and treatment.

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Section: Discussionmentioning

confidence: 49%

Vaginal Calculus Formation on Exposed Midurethral Sling Mesh

Langer,

Saeed,

Barrett

et al. 2024

Case Reports in Obstetrics and Gynecology

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

Griffiths

Towers

Yaklic

2017

Case Reports in Obstetrics and Gynecology

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Background Vaginal stones may form in the setting of mesh exposure with urinary incontinence. This report serves to help understand the presentation, evaluation, and management of vaginal urinary stones. Case A 68-year-old female presented with a vaginal calculus. She had a history of anterior and posterior polypropylene mesh placement for prolapse 7 years earlier and urinary incontinence. The stone was identified on a portion of exposed mesh and removed in office. Pathology confirmed urinary etiology. The exposed mesh resolved with topical estrogen. Cystourethroscopy excluded urinary fistula and bladder mesh erosion. Conclusions When identified, a vaginal calculus should be removed and evaluated for composition. Cystourethroscopy should be performed to assess potential urinary tract fistulas and mesh erosion. Additional imaging should be considered.

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