Large primary vaginal stone in a woman with multiple sclerosis

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....

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Bibliographic Details
Published in:BMJ case reports 2020-10, Vol.13 (10), p.e235103
Main Authors: Aronson, S Lot, Hovius, Marina C, Janszen, Erica W M
Format: Article
Language:English
Subjects:
Bladder
Calcium phosphates
Calculi - diagnosis
Calculi - etiology
Case reports
Cellular biology
Cerebral palsy
Cervix
Diagnosis, Differential
Disability
Endosonography
Episiotomy
Female
Fistula
Follow-Up Studies
General anesthesia
Gynecology
Humans
Menstruation
Middle Aged
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - diagnosis
Rare Disease
Urinary incontinence
Urinary tract infections
Urine
Uterus
Vagina
Vagina - diagnostic imaging
Vaginal Diseases - diagnosis
Vaginal Diseases - etiology
Wheelchairs
Womens health
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Summary: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.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235103