Aronson S Lot, Hovius Marina C, Janszen Erica W M
Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
BMJ Case Rep. 2020 Oct 30;13(10):e235103. doi: 10.1136/bcr-2020-235103.
Vaginal stones are rare and therefore a delay in accurate diagnosis often occurs. We present a 54-year old woman with multiple sclerosis who was diagnosed with a primary vaginal stone. Initially, she presented with recurring urinary tract infections (UTI) and macroscopic haematuria to the urologist. A cystoscopy showed no abnormalities. Because of persistent bleeding, she was referred to the gynaecologist, and on gynaecological examination, a vaginal stone was revealed. Stone formation was likely to be the result of urinary pooling due to incontinence, which was caused by a neurogenic bladder. Other contributing factors were prolonged recumbency, threads of an intrauterine device and a UTI. The presence of a vesicovaginal fistula was excluded by testing with methylene blue. The stone was surgically removed and composed of 70% struvite and 30% apatite. The patient was treated for decubitus ulcerations of the vaginal wall with estriol (Synapause-E3). Follow-up was uneventful.
阴道结石较为罕见，因此常常会出现准确诊断延迟的情况。我们报告一位54岁的多发性硬化症女性患者，她被诊断为原发性阴道结石。最初，她因反复出现尿路感染（UTI）和肉眼血尿就诊于泌尿科医生。膀胱镜检查未发现异常。由于持续出血，她被转诊至妇科医生处，妇科检查时发现了阴道结石。结石形成可能是由于神经源性膀胱导致的尿失禁引起尿液积聚所致。其他促成因素包括长期卧床、宫内节育器丝线和尿路感染。通过亚甲蓝试验排除了膀胱阴道瘘的存在。结石通过手术取出，其成分70%为鸟粪石，30%为磷灰石。患者使用雌三醇（Synapause-E3）治疗阴道壁褥疮性溃疡。随访情况良好。
