Vaginal foreign body
Background
- Patients may be reluctant to provide history due to fear or embarrassment
- Foreign bodies most commonly found to be:
- Retained tampon
- Sex toys or other items used for sexual stimulation
- Packets of drugs
- Toilet paper
- Pieces of cloth or small toys (in young girls)
Clinical Features
- Vaginal discharge, chronic
- Often malodorous
- Consider foreign body in all prepubertal patients with discharge, especially if bloody or brown
- Vaginal bleeding
- Vulvovaginitis
- Pelvic pain
Differential Diagnosis
- Infection
- Bacterial Vaginosis, Trichomonas, chlamydia/gonorrhea infection, Candida Vaginitis
- Endometritis, PID, TOA
- Ob/gyn conditions
- Ectopic pregnancy, abortion (threatened, incomplete, or septic)
- Pelvic thrombophlebitis
- Ovarian torsion, ovarian cyst hemorrhage/rupture
- Dysmenorrhea, endometriosis
- Genitourinary
- Cystitis, Pyelonephritis
- Renal colic
- Gastrointestinal
Evaluation
- Visualization may be aided by irrigation with normal saline
- Children <7yo or uncooperative patients may require vaginoscopy in the OR with anesthesia
- Plain films sometimes help identify radiopaque objects
- Some items may be identifiable on ultrasound or MRI
Management
- Remove object, either manually or with saline irrigation
Disposition
See Also
External Links
References
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