Vaginal Foreign Bodies
Exams and Tests for Vaginal Foreign Bodies continued...
For young girls, any visit to a doctor's office can be frightening. If a foreign object is suspected in a young girl, the physician may gently examine the vulva and vaginal entrance by separating the labia and glimpsing the foreign object. This may allow removal in the office through such techniques as warm water flushing of the vagina, but other larger objects may require sedation or examination under anesthesia for removal.
An adolescent patient may easily have a foreign body removed from the vagina in the outpatient setting. This may also hold true for adults. Visualization of the foreign body using a speculum and removal with a forceps may be the most efficient treatment.
- Unusual objects or those that may disrupt to the vaginal wall may require sedation or anesthesia for removal, and to complete a thorough exam of the vagina and cervix.
- If an object has been present in the vagina for a long time, that object may cause erosion into the wall of the vagina. Acute placement of an unusual object in the vagina may cause perforation of the vaginal wall and secondary symptoms of an intra-abdominal infection. (For example, an unusual case report in the emergency medicine literature revealed placement of wood sticks in the vagina of an adult female 2 years before she began having pain in her hips. The sticks had been inserted in order to attempt to terminate a pregnancy. The sticks, however, remained in the vagina and eventually migrated through the vaginal wall to produce the hip pain.)
- Although examination generally reveals the presence of a foreign body, some imaging techniques may also be helpful. These may include a CT (computerized tomography) scan or an abdominal X-ray. Ultrasonography may also assist in the location of a foreign body in the vagina or pelvis.
Bacterial infections or alteration in the normal bacterial flora of the vagina may be due to the presence of a foreign body altering the usual acidic environment of the vagina. Removal may be performed with the forceps or with a warm water irrigation of the vagina. Once the foreign object is moved, antibiotics are generally not needed.
In children, vaginal lavage or irrigation is the method of choice to remove small bits of fibrous tissue. Removal of larger objects may be accomplished in the outpatient setting or may require sedation or evaluation in the operating room. Analgesia or anesthesia at the time of removal may make the procedure more comfortable.
Teenagers and older women may generally have foreign bodies removed in the outpatient setting; however, those patients who are unable to cooperate for an exam may also benefit from sedation or removal in the operating room.
Larger objects and those causing pain after placement in the vagina may require anesthesia for complete removal and inspection of the vaginal walls. These more complex procedures may require antibiotics.