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BMJ Case Reports 2018; doi:10.1136/bcr-2018-225695
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Bladder calculi causing irreducible urogenital prolapse

  1. Russell Stanley2
  1. 1Department of Obstetrics and Gynecology and Urology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  2. 2Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  1. Correspondence to Dr Charles D Thompson, Charles.thompson{at}ttuhsc.edu
  • Accepted 8 August 2018
  • Published 12 September 2018

Summary

Over 200 000 surgeries for vaginal prolapse are done annually, and these are rarely urgent. However, when the rare event of bladder stones causes incarcerated procidentia, surgical intervention should not be delayed, due to unrelenting pain and end-organs effects. We present such a case below. A 71-year-old woman presents to our department with massive uterovaginal and rectal procidentia. This massive prolapse was found to be irreducible due to numerous dahllite stones in the bladder, and was causing obstructive uropathy with left-sided hydronephrosis. A multidisciplinary approach was necessary to surgically correct the prolapse and implement complete removal of all the stones. The simultaneous occurrence of uterovaginal prolapse, rectal prolapse and urolithiasis is uncommon. Stone formation is a result of chronically infected urine presenting a nidus for stone formation. This presentation has occurred very rarely over the last 70 years of the world’s literature. Surgical cures can be achieved by either the vaginal or abdominal routes but should be treated emergently to alleviate pain, prevent renal impairment from obstructive uropathy and decrease infectious morbidity.

Footnotes

  • Contributors All the authors had substantial original contributions to the writing of this article, have read and approved all edits and are responsible for the content thereof. Specific contributions to the article are as follows: CDT: lead author, literature review and final editor of article. BEH: author of the detailed case presentation. RS: contributing author of discussion and literature review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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