A 57-year-old woman presented with a hard mass in the vagina. In 2009 she underwent a spiral sling procedure for severe stress incontinence. She had not attended postoperative follow-up examinations despite recurrence of stress incontinence symptoms around 18 months after surgery. She reported no pain or abnormal vaginal bleeding. Physical examination revealed a stone measuring around 3 cm along the right vaginal sulcus attaching to the exposed mesh. Vaginal stone removal was performed under general anaesthesia. Dissection was done along the exposed mesh up to the retropubic space as far as possible (Fig). A total of 1.5 cm vaginal mesh was removed together with the stone. Cystoscopy was also performed to exclude any tape erosion or fistula and findings were normal. The vaginal stone was confirmed to be largely comprised of calcified material; basophilic fibrillary basophilic clumps admixed with refractile suture material and rare detached squamous epithelium. Gram and Grocott section confirmed bacteria morphologically compatible with Actinomyces species.
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