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Complete Transvaginal Surgical Management of Multiple Bladder Calculi and Obstructed Uterine Procidentia

Hudson, Catherine O. MD*; Sinno, Abdulrahman K. MD*; Northington, Gina M. MD, PHD; Galloway, Niall T.M. MD; Karp, Deborah R. MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2014 - Volume 20 - Issue 1 - p 59–61
doi: 10.1097/SPV.0b013e318288ad82
Case Reports

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.

From 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.

Reprints: Catherine O. Hudson, MD, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322. E-mail: cohudso@emory.edu.

No funding was received for this work.

The authors have declared they have no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins