Vaginal stone in a male patient with true hermaphroditism

Abstract

31歳男, 染色体は46, XX, 4歳時に子宮, 性腺の摘出を受け, 真性半陰陽と診断されている.排尿時痛, 血尿を主訴として当科受診, 尿道造影で後部尿道部に径4cmの結石陰影を認め, 尿道鏡にて男性子宮内結石と診断した.経尿道的電気水圧式結石破砕術を行った.残石に対して体外衝撃波結石破砕術及び経尿道的破砕術を行い完全に結石を破砕した.結石成分はリン酸カルシウムと酸性尿酸アンモニウムの混合石であった

A 31-year-old male with true hermaphroditism and a 46, XX karyotype who underwent gonadectomy and extirpation of the internal sex organs at the age of 4 had a large stone 4 cm in diameter in the residual male vagina. He complained of pain on micturition, hematuria, and rectal pressure. Urethroscopy and retrograde urethrography disclosed an ostium of the male vagina in the prostatic urethra, and an impacted intravaginal stone. Transurethral electrohydraulic lithotripsy was performed. Extracorporeal shock wave lithotripsy and transurethral lithotripsy were performed for the residual stones. All stones and fragments were spontaneously passed. The stone was composed of calcium phosphate and ammonium acid urate.