Vaginal Calculi Secondary to Partial Vaginal Outlet Obstruction in Pediatric Patients

Primary vaginal calculus secondary to urethrovaginal fistula with imperforate hymen in a 6-year-old girl

“…One previously described 14-year-old patient with a vaginal stone had a urethrovaginal fistula and vaginal stenosis resulting from pelvic trauma, with subsequent surgical urethral realignment and anterior colporrhaphy [1]. Other causes of primary vaginal stones include an ectopic ureter draining into the vagina, previous operations for bladder exstrophy with urinary incontinence, vaginoplasty with significantly narrowed introitus, and urinary contamination of the vagina in association with incontinence in a neurologically impaired patient [1][2][3].…”

“…It was postulated that the vaginal calculus originated from stasis of urine through the urethrovaginal fistula in the obstructed vagina. This is a unique case of a vaginal calculus with a congenital urethrovaginal fistula associated with an imperforate hymen.Vaginal calculi are extremely rare in children and are classified as primary and secondary [1,2]. Primary vaginal calculi are believed to originate from stasis of urine in the vagina with or without vaginal obstruction, whereas secondary vaginal calculi are the result of crystallization of urinary constituents around a foreign body in the vagina [1,2].…”

“…Primary vaginal calculi are believed to originate from stasis of urine in the vagina with or without vaginal obstruction, whereas secondary vaginal calculi are the result of crystallization of urinary constituents around a foreign body in the vagina [1,2]. Primary vaginal calculi form from the deposition of urinary salts as a result of urinary leakage in association with a urethrovaginal fistula that developed after trauma, vaginal stenosis, or scarring after trauma or surgery; ectopic vaginal ureter; neurogenic bladder; or vaginal outlet obstruction [1][2][3][4][5].We recently treated a 6-year-old girl with a primary vaginal calculus secondary to urethrovaginal fistula and imperforate hymen. The imaging findings and treatment are discussed.…”

Novel approach to vaginal calculus in a girl with urogenital sinus anomaly

“…Size 10F cystoscope was passed through this channel, and the stone was fragmented using electrohydraulic lithotripsy. At a later date, she underwent staged anterior sagittal transvulval mobilization of the urogenital sinus.Primary vaginal stones are reported in association with vesicovaginal and urethrovaginal fistulae and, in conditions causing narrowing of the vaginal introitus [1-4] Urinary stasis and bacterial proliferation appear to contribute to the formation of calculi [5,6]. There are only 4 case reports describing primary vaginal stones in the pediatric literature [6][7][8].…”

“…There are only 4 case reports describing primary vaginal stones in the pediatric literature [6][7][8].…”