GIANT BLADDER STONE IN A PATIENT WITH VESICOVAGINAL FISTULA CAUSED BY BLADDER WALL ISCHEMIA DUE TO UNASSISTED PROLONGED LABOR IN THE AMAZON JUNGLE

INTRODUCTION: Bladder stones are the most common manifestation of lower urinary tract lithiasis, accounting for 5% of urinary tract stones and almost 1.5% of urological hospitalizations. ¹ However, giant vesical stones - weighing more than 100g - are increasingly rare. REPORT: A 65-year-old woman, with no chronic diseases - neither congenital nor acquired, menopaused, G5P5A0, developed a long term vesico-vaginal fistula due to unassisted labor in amazon jungle inlands. Later on a failed surgical attempt to correct it ultimately led to the development of a giant bladder stone, weighting more than 270g in its larger fragment. CONCLUSION: Poor health care assistance was the main cause of each and every complication leading to another, as described. Though uncommon in females, giant bladder stones usually benefit from contaminated environments with altered urinary flow, conditions provided by the patients anatomy