Complete transvaginal surgical management of multiple bladder calculi and obstructed uterine procidentia
Catherine O Hudson1, Abdulrahman K Sinno, Gina M Northington
1From the *Department of Gynecology and Obstetrics,†Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, and ‡Department of Urology, Emory University School of Medicine, Atlanta, GA.
Background:
Bladder calculi are rare in women and are associated with irreducible pelvic organ prolapse. We report a case of irreducible uterine procidentia and bladder calculi that was surgically managed with a complete transvaginal approach.
Case:
A 76-year-old woman presented with irreducible complete uterine procidentia. Bladder stones were appreciated on examination and confirmed with imaging. The patient was managed surgically with transvaginal cystolithotomy, uterus-sparing Lefort colpocleisis, and perineorrhaphy under spinal anesthesia. The patient had an uncomplicated postoperative course without recurrent prolapse or urinary retention at 3-month follow-up.
Conclusion:
The presence of bladder calculi should be considered in the setting of irreducible pelvic organ prolapse. A complete transvaginal approach with cystolithotomy and concomitant obliterative procedure without hysterectomy is a safe and effective alternative to the traditional approach.
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