{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:14Z","timestamp":1787016974026,"version":"build-2736575974"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,5]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2020-235103","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T17:10:59Z","timestamp":1604077859000},"page":"e235103","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Large primary vaginal stone in a woman with multiple sclerosis"],"prefix":"10.1136","volume":"13","author":[{"given":"S Lot","family":"Aronson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina C","family":"Hovius","sequence":"additional","affiliation":[{"name":"Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica W M","family":"Janszen","sequence":"additional","affiliation":[{"name":"Department of 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