# Expanding the limits of vaginal surgery: Transvaginal vesicolithotomy for an incarcerated procidentia: A case report and literature review

## TL;DR

A 75-year-old woman with a bladder stone and severe pelvic organ prolapse underwent a combined vaginal surgery with successful outcomes.

## Contribution

Demonstrates the feasibility of one-step transvaginal vesicolithotomy combined with prolapse surgery.

## Key findings

- Vesicolithotomy via the vaginal route resulted in minimal complications.
- Pelvic organ prolapse may be linked to bladder stone formation.
- One-step vaginal surgery is preferable to abdominal approaches for these cases.

## Abstract

Bladder stones are rare in women. This report presents the case of a woman with a massive bladder stone and incarcerated procidentia. The 75-year-old woman presented to the outpatient clinic with procidentia and recurrent urinary tract infections. Preoperative imaging led to the diagnosis of cystolithiasis. After multidisciplinary counseling the patient underwent a vaginal hysterectomy with bilateral oophorectomy and transvaginal vesicolithotomy. A bladder biopsy was performed to rule out any malignancy. After three days, the patient was discharged with a Foley catheter; 15 days later, the bladder catheter was removed. She had an uncomplicated postoperative course. The presence of cystolithiasis and pelvic organ prolapse remains a challenge both in diagnosis and in treatment. The literature lacks solid evidence on the optimal management of these cases. Although there are no recommendations or consensus for their treatment, it seems that the one-step vaginal approach is preferable to the abdominal route.

•Pelvic organ prolapse may be related to bladder stone formation.•Uterine incarcerated procidentia may be caused by a bladder stone.•Vesicolithotomy is feasible via the vaginal route with minimal complications.•One-step transvaginal vesicolithotomy combined with prolapse surgery is adopted in most of these cases.

Pelvic organ prolapse may be related to bladder stone formation.

Uterine incarcerated procidentia may be caused by a bladder stone.

Vesicolithotomy is feasible via the vaginal route with minimal complications.

One-step transvaginal vesicolithotomy combined with prolapse surgery is adopted in most of these cases.