Authors : Rajiv Kumar Saxena, Deepika S, Vidushi Tewari
DOI : 10.18231/j.ijogr.2019.093
Volume : 6
Issue : 4
Year : 2019
Page No : 420-430
Objective: Vaginal calculus is an unusual finding. In this study we describe a case of primary vaginal
calculus in a rather rare urogenital anomaly- Obstructed hemivagina with ipsilateral renal agenesis
(OHVIRA) syndrome. This syndrome is shrouded in controversies. Here we present a mini review about
vaginal calculus and theory of embryological development of female genital tract as related to OHVIRA
syndrome.
Case: A 50 years-old unmarried lady with primary amenorrhoea presented with pain abdomen. She was
found to have calculus in the pelvis by x-ray which was thought to be bladder calculus initially. On local
examination the vaginal opening was absent. Imaging studies such as NCCT and MRI confirmed that it
is a vaginal calculus, located below the uterine cervix, with absent right kidney. She was diagnosed with
OHVIRA syndrome with colpolithiasis. On laparotomy she was detected to have unicornuate uterus with
absence of right Mullerian structures. The calculus occupied the whole of upper part of vagina, which
was a blind pouch. The patient underwent total abdominal hysterectomy, left salpingo-ophorectomy with
removal of calculus after opening the vaginal vault. Postoperative recovery was uneventful. Chemical
analysis of the calculus revealed calcium magnesium oxalate which is of hematic origin.
Keywords: Primary vaginal calculus, Mullerian duct anomaly, Obstructed hemivagina, OHVIRA syndrome, Herlyn-Werner-Wunderlich syndrome.