Vesical Calculus in a Vaginal Cystocoele

A Mohammedan multipara was admitted in the second stage of labour. There was delay in the advance of the head through the lower canal. Examination revealed that a normal labour was taking place, but a hard mass was felt in the anterior vaginal wall, and a cystocoele was seen to bulge below the pubic arch obstructing the progress of the head. A no. 10 male silver catheter was passed per urethrem, with the tip pointing posteriorly, and, after taking a specimen of urine, the catheter was felt to grate against a stone in the cystocoele. The bladder was incised through the anterior vaginal wall, and a stone about the size of a walnut removed. The fistula so formed was carefully sutured in two layers, and delivery completed by forceps so as to avoid prolonged pressure on the sutured wound.