Vesical calculus as a cause of labour dystocia. Report of a case.

Reports of cases of calculus of the bladder obstructing labour are difficult to find in the literature, probably because this is an extremely rare phenomenon. Smellie has recorded a case of a large calculus which was forced out of the bladder during labour, resulting in a permanent fistula. In his monograph on the subject in I875 Hugenberger referred to 23 cases. In many of them great injury occurred, while in others the tumour was removed during labour or pushed out of the way (quoted by Chassar Moir3). McClintock4 refers to a case in which a large stone was removed from a woman seven months pregnant, without disturbing the pregnancy. Very few cases have been recorded in recent years but Bride1'2 reported one in which a vesical calculus was diagnosed accidentally on a prenatal X-ray. As it lay below the presenting part and could not be pushed above it, Caesarean section was performed, to avoid damage to the bladder during labour. Later the stone was removed; it weighed 4 oz. and measured 6.5 by 6 cm. The condition of vesical calculus obstructing labour is so rare that the following case appears to be worth recording.