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      Vaginal stones caused by urethrovaginal fistula : A case report

      case-report

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          Abstract

          Rationale:

          Vaginal stone is a rare condition that is often misdiagnosed due to its low incidence. It can be divided into 2 types, primary vaginal and secondary vaginal, based on the etiology of the disease. Vaginal stones involve pathologic calcification. The formation of vaginal stones is mainly due to stasis and urine infection. We describe a procedure for the safe extraction of vaginal stones.

          Patient concerns:

          We report a case of a 25-year-old female patient with congenital genitourinary malformation and urethrovaginal fistula. A urogenital tract malformation repair operation was performed before she was 21 years old. Frequency of urination occurred before and after menstruation for 9 years, and dyspareunia occurred for 1 year.

          Diagnoses:

          B ultrasound examination showed a 59 × 55 × 23 mm fusiform region of increased signal intensity in the vagina followed by a sound shadow. We performed a gynecologic examination and found that the long diameter of the vaginal opening was 20 mm. A brown substance observed in her vagina had a hard texture and felt like a stone, and a palpation hand test revealed the size was approximately 60 × 50 mm. A cystoscope was inserted into the urethra and revealed that the broken end of the urethra was connected to the vagina. The proximal broken end of the urethra was 20 mm from the distal end.

          Interventions:

          The purpose of this operation was to make a definite diagnosis and remove the stones. We performed vaginal stone removal surgery and cystoscopy under anesthesia.

          Outcomes:

          We removed the stone successfully. The patient was discharged from the hospital after a smooth recovery without any complications. Follow-up was conducted 1 month after the operation and then every 3 months.

          Lessons:

          Although vaginal stones are rare, we must pay attention to this disease, especially in patients with congenital genitourinary malformations and urethrovaginal or vesicovaginal fistulas. Obstruction of urine discharge combined with repeated urinary tract infection is the main cause of vaginal stone formation. For these patients, follow-up every 3 months, including a physical examination, B-mode ultrasonography of the urinary system and cystoscopy if necessary, can avoid the occurrence of the disease.

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          Most cited references15

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          Vaginal calculus secondary to vaginal outlet obstruction.

          Primary vaginal stones are extremely rare and are often mistaken for bladder calculi on plain radiography. However, intravenous pyelography and sonography can help differentiate between the two. We report a case of a large vaginal stone in a 21-year-old woman referred for apareunia and difficult micturation. The clinical findings of vaginal outlet obstruction and a hard mass anterior to the rectum made us suspect a bladder calculus; however, sonography of the pelvis indicated that the mass was in the vagina. Further examination using a probe to physically define the stone's location confirmed it to be a vaginal calculus. Surgery was performed to repair the outlet obstruction and remove the stone, which permitted the woman to urinate normally and engage in normal sexual relations. Copyright 2004 Wiley Periodicals, Inc.
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            Vaginal calculi secondary to urethrovaginal fistula with vaginal stenosis in a 14-year-old girl.

            The author reports a case of vaginal calculi secondary to urethrovaginal fistula with vaginal stenosis in a 14-year-old girl. The initial urethrovaginal fistula and vaginal stenosis resulted from pelvic trauma after a traffic accident, with subsequent surgical urethral realignment and anterior colporrhaphy without success. The patient had continuous urinary incontinence for a duration of 11 years after surgery, and was finally diagnosed with urethrovaginal fistula with primary multiple vaginal calculi in our hospital. Surgeries were performed to remove the stones and repair the urethrovaginal fistula. Colpoplasty was also given by an obstetrician-gynecologist to solve the vaginal stenosis. After the procedure, the girl urinated normally. At her 3-month follow-up, the patient had no sign of urine leakage.
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              • Article: not found

              Giant Primary Vaginal Calculus Secondary to Vesicovaginal Fistula with Partial Vaginal Outlet Obstruction in a 12-Year-old Girl

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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                November 2019
                22 November 2019
                : 98
                : 47
                : e18003
                Affiliations
                [a ]Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University
                [b ]Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
                [c ]Department of Gynecology and Obstetrics, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, China.
                Author notes
                []Correspondence: Xiaoyu Niu, Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China (e-mail: 2729493428@ 123456qq.com ).
                Article
                MD-D-18-09756 18003
                10.1097/MD.0000000000018003
                6882588
                31764813
                19d90986-03b5-4913-8fdb-e75e85bb0be8
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 4 January 2019
                : 13 August 2019
                : 17 October 2019
                Categories
                5600
                Research Article
                Clinical Case Report
                Custom metadata
                TRUE

                congenital genitourinary malformations,urethra-vaginal fistula,urinary tract infection,vaginal calculus,vesicovaginal fistulas

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