Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. May 11, 2023; 12(3): 28-32
Published online May 11, 2023. doi: 10.5317/wjog.v12.i3.28
Stone accumulation overlying vaginal mesh exposure: A case report
Karissa A Leong, Katherine E Husk
Karissa A Leong, Katherine E Husk, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY 12208, United States
Author contributions: Leong KA and Husk KE contributed to the manuscript writing and editing; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Karissa A Leong, MD, Staff Physician, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Albany Medical Center, 391 Myrtle Ave, Suite 200, Albany, NY 12208, United States. leongk9@amc.edu
Received: January 27, 2023
Peer-review started: January 27, 2023
First decision: March 28, 2023
Revised: April 10, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: May 11, 2023
Processing time: 104 Days and 3.6 Hours
Abstract
BACKGROUND

Vaginal stones are rare with current literature limited to case reports. Vaginal stones are classified as primary or secondary stones. Primary stones form in the vagina when there is urinary stasis. Secondary stones form in the presence of a vaginal foreign body that acts as a nidus for the deposition of urinary salts. Foreign bodies, such as surgical mesh, make vaginal stone formation more likely, particularly in patients with urinary incontinence and conditions that predispose them to urinary calculi formation.

CASE SUMMARY

A 71-year-old female with a history of sacrocolpopexy, hyperaldosteronism, and urgency urinary incontinence presented with vaginal stone accumulation overlying two areas of vaginal sacrocolpopexy mesh exposure. The vaginal stones were initially removed to permit examination, but the stones reaccumulated at the site of the exposed mesh, later requiring definitive surgical management.

CONCLUSION

Patients with vaginal mesh exposure and conditions that predispose them to kidney stones are not ideal candidates for expectant management of mesh exposure, particularly if they have coexisting urinary incontinence. These individuals should be counseled about possible vaginal stone accumulation, and surgical management should be considered.

Keywords: Vaginal stones; Urgency urinary incontinence; Sacrocolpopexy; Mesh complications; Mesh exposure; Case report

Core Tip: Patients with vaginal mesh exposure that have underlying conditions that predispose them to urinary calculi formation may be at increased risk of vaginal stone accumulation at the site of mesh exposure. Expectant management of the mesh exposure likely allows vaginal stones to accumulate as urine is persistently in contact with the foreign body. Definitive surgical management in the form of complete excision of the entire area of exposed mesh should be recommended to patients to avoid vaginal stone accumulation.