Primary vaginal stones are extremely rare and are often mistaken for bladder calculi on plain radiography. However, intravenous pyelography and sonography can help differentiate between the two. We report a case of a large vaginal stone in a 21-year-old woman referred for apareunia and difficult micturation. The clinical findings of vaginal outlet obstruction and a hard mass anterior to the rectum made us suspect a bladder calculus; however, sonography of the pelvis indicated that the mass was in the vagina. Further examination using a probe to physically define the stone's location confirmed it to be a vaginal calculus. Surgery was performed to repair the outlet obstruction and remove the stone, which permitted the woman to urinate normally and engage in normal sexual relations.
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