Reviewed by: Zhou Mingfang (Beijing Ditan Hospital, Capital Medical University)
1. How to find and treat vaginal foreign bodies?
Some items are designed for use in a woman's vagina, including tampons, vaginal suppositories, drugs used through the vagina, etc., while other items should not be intentionally or unintentionally placed in the vagina, and doctors will call certain objects found in the vagina "foreign bodies".
These foreign bodies may cause some physical symptoms or remain asymptomatic for a long time.
Small objects inserted into the vagina usually do not cause pain. Certain abnormal objects (usually objects larger than the normal vaginal diameter) may cause pain because they are too large, while others may cause pain due to their sharp edges.
While a vaginal foreign body can cause a variety of symptoms, the most common symptoms are bleeding or vaginal discharge accompanied by foul odor, as well as less common symptoms such as pain or urinary tract discomfort.
Perforation caused by foreign bodies entering the abdominal cavity through the vagina may also cause acute abdominal symptoms and may also be accompanied by systemic infection, but this is very rare.
Second, the reason
The most common vaginal foreign bodies in young children come from a small amount of fibrous material from clothing and carpets, more commonly toilet paper, and young children may also place objects in the vagina while exploring their own bodies, but objects may be forgotten there or cannot be removed once placed in the vagina, and other common objects include marker caps or crayons.
Objects found in children are usually small and do not cause pain because they are too large, and children usually do not place objects larger than the entrance to the vagina due to the discomfort they can cause.
Female adolescents can start using tampons after menarche, and occasionally tampons are forgotten and may not be removed for days. Damage to the condom may cause latex or non-latex material to remain in the vagina.
While small objects placed in the vagina may be asymptomatic for a period of time, larger objects may cause immediate pain or discomfort, which requires medical attention.
3, Symptoms
Common symptoms of a vaginal foreign body include the following:
Vaginal discharge, usually foul-smelling, yellow, pink, or brown;
Vaginal bleeding, especially minor bleeding;
Vaginal itching or odor;
Discomfort with urination;
Discomfort caused by vaginal discharge leads to a sensation of skin irritation;
Pain in the abdomen or pelvis due to the placement of large objects in the vagina or perforation of a foreign body into the abdominal cavity;
Redness of the skin;
Swelling of the vagina and vaginal openings;
A rash appears in the vaginal area.
Symptoms of vaginal discharge may be caused by vaginitis, sexually transmitted diseases or even Candida infections, and the presence of a vaginal foreign body may alter the normal bacterial flora of the vagina, leading to "vaginitis" that requires repeated treatment.
If the foreign body persists, repeated use of antibiotics or other medications will not eliminate the symptoms.
Objects left in the vagina rarely lead to serious complications, however, several cases of pelvic abscesses and secondary scarring have been reported.
4. When should I seek medical attention?
If the vaginal discharge has a change in character, especially if the secretion has a foul odor or abnormal color, it is necessary to seek immediate medical attention, and the presence of a foreign body in the vagina may cause abnormal vaginal bleeding.
If a foreign body has been inserted in the vagina and the foreign body may still be in place, doctor should be informed. Sometimes adult or teenage women may remember having a tampon placed, but cannot remove it from the vagina.
Sedation or anesthesia may be required to avoid pain when removing an uncommon foreign body, which is especially needed in children and adults who are unable to cooperate with a vaginal examination. Some hospitals allow the removal of foreign bodies after sedation in the emergency room without having to go to the operating room.
Image source: Stand Cool Helo
5. Inspection
Vaginal foreign bodies in children are more common than in adolescents or adult women, and children may not be able to provide a specific history of vaginal foreign bodies, but some children will say that something is missing in the vagina. In addition to asking specific information about the vaginal foreign body, doctors also ask for a medical history and perform a physical examination.
Doctors ask questions about couple life or physical abuse.
The method used to diagnose and look for a foreign body depends on the age of the female patient and sometimes on the time the object is placed in the vagina.
For little girls, it is difficult to see a doctor. If a foreign body is suspected of being in the body of a little girl, the doctor will gently examine the foreign body separately.
Foreign bodies can be removed in the examination room by methods such as vaginal irrigation with warm water, but other larger objects may need to be examined under sedation or anesthesia before they can be removed.
Adolescents and adults may be more likely to remove a vaginal foreign body on an outpatient basis. Using a speculum to look at the foreign body and remove it with forceps, may be the most effective treatment.
Abnormal objects and objects that may damage the vaginal wall may require sedation or anesthesia to remove, and a thorough examination of the vagina and cervix is required.
If the object is present in the vagina for a long time, it may erode the vaginal wall, and a foreign body placed in the vagina recently may lead to secondary symptoms such as perforation of the vaginal wall and intra-abdominal infection.
Although the presence of a foreign body can generally be detected by physical examination, some imaging tests, including CT or abdominal x-rays, can also help determine the location of the foreign body in the vagina or pelvis.
6. Treatment
The presence of a foreign body may alter the normal environment of the vagina, resulting in a bacterial infection or altering the normal bacterial flora of the vagina, or it can be removed by flushing with forceps or warm vaginal water, and the foreign body is usually removed without antibiotics.
Adolescents and older women can usually remove foreign bodies on an outpatient basis, but for patients who are unable to cooperate with the examination, they may need to be sedated in the operating room to remove foreign bodies.
Large, painfully larger objects in the vagina may require anesthesia to be completely removed and the vaginal wall needs to be examined, and more complex procedures may require antibiotics.
7. Drugs
Larger and painfully infected objects require anesthesia to relieve pain, vaginal muscles to relax, and objects that move from the vagina to the abdomen or other parts of the body need to be surgically removed.
After the foreign body is removed and antibiotics are used, symptoms such as infection, fever, pain, and vaginal discharge disappear quickly.
8. Next steps
If vaginal discharge, bleeding, odor, or urinary tract symptoms continue to occur after the foreign body has been removed, it is recommended that the doctor re-evaluate it.
9. Follow-up
If symptoms disappear after the foreign body is removed, follow-up may not be required.
If the doctor is unsure whether the foreign body has been removed in its entirety, or if a complication (such as secondary infection) is diagnosed when the foreign body is removed, another examination may be recommended.
10. Prevention
Prevention of vaginal foreign body-related infections begins with good vulvar and vaginal hygiene.
Parents should teach young children to maintain hygiene in this area by wiping the perineum from front to back, which reduces the number of bacteria that may enter the vagina, and poor perineal hygiene may cause vulva or vaginal irritation.
Parents can also prevent vaginal foreign bodies by talking to their children about the body and teaching the correct names of body parts.
Knowing the correct names of body parts allows children to better communicate with problems, for example, when pain, discharge, or possible abuse occurs, children can describe these body parts to adults.
For older women, good hygiene includes limiting the amount of time objects remain in the vagina, and tampons should not be used for more than 6 to 8 hours.
Medications to treat vaginal infections or irritations should be prescribed by a doctor, patients may often misjudge the cause of vaginal discharge, cleaning the vagina does not require vaginal irrigation or the use of vaginal lotion, which washes away normal bacteria that help fight infection and may increase the risk of infection.
Satisfactory cleaning of the vaginal area through showers and tubs can be achieved.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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