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Extraction of a large vaginal calculus utilizing an ear, nose, throat mallet and osteotomes
Kristen Buono1, Paul Wadensweiler2, Felicia Lane2
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, 333 City Blvd West, Suite 1400, Orange, CA, 92868, USA. kristenkbuono@gmail.com.
Background:
Previous case reports on vaginal calculi extraction have described the removal of small calculi facilitated via episiotomy or transabdominal incision. This surgical video demonstrates a novel technique of transvaginal extraction of a large calculus utilizing an ear, nose, and throat (ENT) mallet and osteotomes.
Case:
An 86-year-old female with urgency incontinence and limited mobility presented with obstipation and was found to have an 8.8 cm vaginal calculus. She had a history of prior vaginal mesh exposure after a mid-urethral sling that was managed expectantly without surgical resection. Cystourethroscopy and anoscopy excluded fistula. The calculus was extracted utilizing an ENT mallet and osteotomes in < 90 min, and no recurrent vaginal mesh exposure was identified.
Conclusion:
An ENT mallet and osteotomes can be safely utilized to expedite extraction of a vaginal calculus.
