Vesico-vaginal fistula with a giant vesico-vaginal stone: a case report

The patient, a 73-year-old woman, had undergone hysterectomy and irradiation therapy 26 years ago. On September 4, 1997, the patient was referred to our hospital, and presented with low grade fever and lower abdominal dull pain of a one-month duration. Radiologic and vaginal examinations revealed bilateral hydronephrosis and a giant stone lying down between the bladder and vagina. Vaginal incontinence showed the presence of the vesico-vaginal fistula. She underwent bilateral ureterocutaneostomy and cystolithotomy. A giant vesico-vaginal stone was removed by using a hammer and chisel. It weighed 180 g. The stone was composed of calcium phosphate and magnesium ammonium phosphate. Persistent infection of the bladder and the vagina may have been a possible etiological factor of the vesico-vaginal stone formation. Three weeks after the operation, bilateral hydronephrosis was improved.