Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 6894

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

LETTER TO EDITOR Table of Contents   
Year : 2000  |  Volume : 10  |  Issue : 3  |  Page : 191-192
Vesical calculus formation on a perforating vaginal foreign body


Dept of Radiodiagnosis, Command Military Hospital, Pune, India

Click here for correspondence address and email
 

How to cite this article:
Satija L, Dhagat P, Sharma A, Satija N. Vesical calculus formation on a perforating vaginal foreign body. Indian J Radiol Imaging 2000;10:191-2

How to cite this URL:
Satija L, Dhagat P, Sharma A, Satija N. Vesical calculus formation on a perforating vaginal foreign body. Indian J Radiol Imaging [serial online] 2000 [cited 2019 Oct 22];10:191-2. Available from: http://www.ijri.org/text.asp?2000/10/3/191/30600
Sir,

A thirty-years-old woman of poor socio-economic strata presented with long-standing complaints of frequency, urgency and burning of micturition. She was 155 cm tall and of small frame. On examination, she was pale but not febrile. Her heart rate and blood pressure were within normal range. Urinalysis showed presence of pus cells and RBCs suggesting urinary tract infection. A urine culture grew E. Coli sensitive to nalidixic acid, norfloxacin and gentamicin. Her pelvic and transvaginal sonography revealed presence of a lobulated vesical calculus attached to a densely echoic linear object. The other end of this linear object was in the vagina [Figure - 1]. This was diagnosed as a foreign body needle in the vagina, perforating through the vaginal wall into the urinary bladder with calculus formation on the vesical part of this needle. The presence of a lobulated calculus with an embedded needle in the urinary bladder area was also documented on a plain radiograph of the pelvis [Figure - 2]. On per vaginal examination the tip of the needle was felt on the fingertip.

On subsequent interrogation she confessed to have been beaten to unconsciousness by her husband who after that had deserted her almost a year before. We presumed that he must have inserted this needle while she was unconscious. She never noticed it as she remained symptomless and abstained from coitus. She was operated by the suprapubic route and the vesical calculus with the embedded needle was removed. She made an uneventful recovery.

We in our practice have come across many foreign bodies of different kinds, inserted in natural orifices. This however was the first case of a metallic needle vaginal foreign-body that had perforated through the antero-superior vaginal wall to enter the urinary bladder. A calculus had formed over the vesical part of the needle, which acted as a nidus. As the patient remained symptomless and abstained from coitus, the foreign body was not detected. In medical literature, the list of neglected vaginal foreign bodies leading to various symptoms and complications is very long. The symptoms include urinary tract infection [1] that was present in our patient mainly due to the vesical calculus and not due to the vaginal foreign body. Pelvic pain and foul smelling vaginal discharge with or without blood tinge [2] were not present.

Complications described include calculus formation over a foreign body forming a vaginolith [3] or perforation through the vaginal wall into the peritoneal cavity [4] or formation of vesico-vaginal or recto-vaginal fistulae [5]. All the foreign bodies when left for long at one place act as a nidus for calculus formation as happened in our patient. The kind of neglected foreign bodies reported range from gauzes and tampons to caps of pens and bottles.

 
   References Top

1.Yu TJ. Urinary tract infection with a neglected vaginal foreign body. J. Urol. 1997; 157: 1475-76.   Back to cited text no. 1    
2.Wittich Agency Condition, Murray JE. Intravaginal foreign body of long duration: a case report. Am J Obstet Gynecol. 1993; 169: 211-212.   Back to cited text no. 2    
3.Dalela D, Agrawal R, Mishra VK. Giant vaginolith around an unusual foreign body - an uncommon cause of urinary incontinence in a girl. Br J Urol 1994; 5: 673-674.   Back to cited text no. 3    
4.O'Hanlan KA, Westphal LM. First report of a vaginal foreign body perforating into the retro peritoneum. Am J Obstet Gyecol 1995; 173: 962-964.   Back to cited text no. 4    
5.Anderson PG, Anderson M. An unusual case of rectovaginal fistula. Aus NZ J Surg 1993; 63: 148-149.  Back to cited text no. 5    

Top
Correspondence Address:
L Satija
Dept of Radiodiagnosis, Command Military Hospital, Pune
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions


    Figures

[Figure - 1], [Figure - 2]

This article has been cited by
1 Foreign bodies in the urinary bladder
Shaikh, A.R., Shaikh, N.A., Abbasi, A., Soomro, M.I., Memon, A.A.
Rawal Medical Journal. 2010; 35(2): 194-197
[Pubmed]
2 Puzzling groin pain in a 15-year-old boy
Ashworth, S.W., Hurtado, T.R., Cuenca, P.J., Wedmore, I., Kang, C.S.
Journal of Emergency Medicine. 2005; 28(1): 83-85
[Pubmed]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References
    Article Figures

 Article Access Statistics
    Viewed2939    
    Printed88    
    Emailed1    
    PDF Downloaded0    
    Comments [Add]    
    Cited by others 2    

Recommend this journal