title: Complete transvaginal surgical management of multiple bladder calculi and obstructed uterine procidentia.
abstract: BACKGROUND
  Bladder calculi are rare in women and are associated with irreducible pelvic organ prolapse. We report a case of irreducible uterine procidentia and bladder calculi that was surgically managed with a complete transvaginal approach.
  
  
  METHODS
  A 76-year-old woman presented with irreducible complete uterine procidentia. Bladder stones were appreciated on examination and confirmed with imaging. The patient was managed surgically with transvaginal cystolithotomy, uterus-sparing Lefort colpocleisis, and perineorrhaphy under spinal anesthesia. The patient had an uncomplicated postoperative course without recurrent prolapse or urinary retention at 3-month follow-up.
  
  
  CONCLUSIONS
  The presence of bladder calculi should be considered in the setting of irreducible pelvic organ prolapse. A complete transvaginal approach with cystolithotomy and concomitant obliterative procedure without hysterectomy is a safe and effective alternative to the traditional approach.
authors.affiliation: From the *Department of Gynecology and Obstetrics,†Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, and ‡Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Catherine O
authors.initials: CO
authors.lastname: Hudson
authors.forename: Abdulrahman K
authors.initials: AK
authors.lastname: Sinno
authors.forename: Gina M
authors.initials: GM
authors.lastname: Northington
authors.forename: Niall T M
authors.initials: NT
authors.lastname: Galloway
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Karp
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*