74-year-old female patient referred from Gynaecology Outpatient Clinic to Urology for recurrent urinary tract infections (UTI) with hypogastric pain of at least six months' duration.
Her personal history includes a hysterectomy via the vagina for uterine prolapse seven months ago in another centre, requiring readmission 18 days after surgery for fever and pain, with a diagnosis of vaginal vault abscess that drained spontaneously, with the clinical picture disappearing; the tests performed on admission showed: ECHO and CT scan of vaginal vault abscess with no other findings. No DM. No hypertension. No known allergies. No haematuria. No cramps. Sporadic urinary tract infections. G2 A0V2, no leakage.

When she was referred to our clinic for urinary tract infection and UTI, she was accompanied by a simple urinary tract X-ray which was reported as normal, although a weakly calcified outline was clearly seen in the pelvis in the bladder area, and a transvaginal ultrasound scan reported probable bladder lithiasis, a diagnosis for which she was referred to the Urology Department of our centre together with the repeated urinary tract infections.

Given the finding in the accompanying simple X-ray and transvaginal ultrasound with intravesical lithiasis, non-mobile and with the surgical history referred to, the presence of an intravesical foreign body is suspected from the outset due to probable loss of material used in surgery.
Urethrocystoscopy was performed on the same day as the consultation to confirm the suspected diagnosis, which was confirmed, and a large "gauze pellet" was observed adhered to the bladder wall, which could not be moved because it was calcified; a pelvic CT scan was requested to assess the extension and size as well as the relationship with the area.

With the definitive diagnosis of intravesical lithiasis due to a foreign body, probably abandoned during the hysterectomy surgery, it was proposed to extract it by cystoslitectomy or more correctly "cystogasomectomy" by means of an open bladder opening, finding the foreign body described.
After a good evolution the patient is asymptomatic, the repeated urinary tract infections have disappeared, although in the two years of follow-up she has had an isolated episode, the patient leads an absolutely normal life.

