The unusual case of vaginal calculus in an eighty-four-year-old woman: a case report

Background: Vaginal stones are rare, and their presence brings a challenge to the gynecologist's diagnostic acumen. Most information about them is discussed in case reports, which have suggested important diagnostic clues such as presence of a fistula, urogenital malformation, or other physical condition that would encourage urine to pool. We report on the oldest known patient to present with a vaginal stone and who did not have any of these common symptoms. Case Description: We report on an elderly, gravida five para five female with history of carotid stenosis, hyperlipidemia, hypertension, stroke, depression and mild dementia, stress incontinence and vaginal hysterectomy 20 years prior presenting to our office with a growing "hard knot" in her vagina. She was otherwise relatively healthy and active. Exam under anesthesia revealed a 2.5 cm x 2.0 cm x 1.2 cm stone without evidence of rectal involvement or vesicovaginal fistula. The stone was removed, and our patient made a full recovery without residual symptoms. Conclusions: This patient lacked common risk factors for vaginal calculus and discovering patient specific risk factors and preventative measures thereafter are important for prevention of recurrence. It is the purpose of this report to highlight vaginal calculi and to explore diagnostic and treatment options to aid others who may come across this unusual condition.