Reviewer: Zhou Mingfang (Beijing Ditan Hospital Affiliated to Capital Medical University)
First, how to detect and deal with vaginal foreign bodies?
Some items are designed to be used in a woman’s vagina, including tampons, vaginal suppositories, drugs used through the vagina, etc., while other items should not be placed in the vagina, intentionally or unintentionally, Doctors call certain objects found in the vagina a “foreign body.”
These foreign objects may cause some physical symptoms or remain asymptomatic for long periods of time.
Small objects inserted into the vagina usually do not cause pain. Certain abnormal objects (usually larger than the normal vaginal diameter) can cause pain by being too large, and others can be painful because of their sharp edges.
While a foreign body in the vagina can cause a variety of symptoms, the most common symptoms are bleeding or foul-smelling vaginal discharge, and less common symptoms such as pain or urinary discomfort.
Perforation caused by a foreign body entering the abdominal cavity through the vagina can also lead to acute abdominal symptoms and systemic infection, but this is very rare.
Second, the reason
The most common vaginal foreign bodies in young children come from small amounts of fibrous material from clothing and carpets, more commonly toilet paper, and young children may also place objects in the vagina while exploring their bodies, but Objects may be left in place or cannot be retrieved once placed in the vagina, other common objects include marker caps or crayons.
Objects found in children are usually small and not too large to cause pain, and children usually do not place objects larger than the vaginal entrance due to discomfort.
Adolescent females can start using tampons after menarche, and occasionally tampons are forgotten and may not be removed for days. A broken condom can leave latex or non-latex material 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 requiring medical attention.
Three, 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 from vaginal discharge causes skin irritation;
Abdominal or pelvic pain due to placement of a large object in the vagina or perforation of a foreign body into the abdominal cavity;
Redness of the skin;
Vaginal swelling and vaginal opening;
A rash in the vaginal area.
Symptoms of vaginal discharge can be caused by vaginitis, sexually transmitted diseases or even candidiasis, and the presence of a foreign body in the vagina may alter the normal bacterial flora of the vagina, resulting in “vaginitis” requiring repeated treatment “.
If the foreign body remains, repeated antibiotics or other medicines will not clear the symptoms.
Objects left in the vagina rarely lead to serious complications, however, there have been several case reports of pelvic abscesses and secondary scarring.
4. When should I seek medical attention?
If the vaginal discharge changes, especially if the discharge is foul-smelling or unusual in color, seek medical attention immediately. A foreign body in the vagina may cause abnormal vaginal bleeding.
If a foreign body has been placed in the vagina, and the foreign body may still be in place, you should tell your doctor. Sometimes an adult or teenage woman may remember having a tampon in place but not be able to remove it from the vagina.
Sedation or anesthesia may be needed to avoid pain when removing an unusual foreign body, especially in children and adults who cannot cooperate with vaginal examinations. Some hospitals allow foreign bodies to be removed after sedation in the emergency room without going to the operating room.
Image source: Zhanku Hailuo
V. Check
Vaginal foreign bodies are more common in children than teenage or adult women, and children may not be able to provide a specific history of vaginal foreign bodies, but some children will report that something is missing in the vagina. In addition to asking specific information about a vaginal foreign body, your doctor will ask for a medical history and perform a physical exam.
The doctor will ask questions about marital 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 how long the object has been placed in the vagina.
Seeing a doctor can be difficult for little girls. If a foreign body is suspected in the little girl, the doctor will do a gentle examination separately to look for the foreign body.
Foreign objects can be removed in the office, such as by rinsing the vagina with warm water, but other larger objects may require examination under sedation or anesthesia before removal.
Adolescents and adults may be more likely to remove vaginal foreign bodies in an outpatient setting. Viewing the foreign body with a speculum and removing it with forceps may be the most effective treatment.
Anomalous objects and objects that could disrupt the vaginal walls may require sedation or anesthesia to remove, and a thorough examination of the vagina and cervix.
If an object is in the vagina for a long time, it may erode the vaginal wall, and a foreign object recently placed in the vagina may cause secondary symptoms such as vaginal wall perforation and intra-abdominal infection.
Although a physical examination can generally detect the presence of a foreign body, some imaging tests can also help, including CT or abdominal X-rays, and ultrasound can also help determine the location of the foreign body in the vagina or pelvis .
6. Treatment
The presence of foreign bodies may alter the normal environment of the vagina, leading to bacterial infection or altering the normal bacterial flora of the vagina. The foreign body can also be removed with forceps or by rinsing with warm vaginal water. Antibiotics are usually not required.
Adolescent and older women can often have foreign bodies removed in an outpatient setting, but patients who are unable to cooperate may require sedation in the operating room to remove the foreign body.
Large, painful objects in the vagina may require anesthesia for complete removal, inspection of the vaginal wall, and antibiotics for more complex procedures.
VII. Drugs
Larger and painfully infected objects require anesthesia for pain relief, vaginal muscles to relax, and objects that move from the vagina to the abdomen or other parts of the body require surgical removal.
Symptoms such as infection, fever, pain, and vaginal discharge all go away quickly after the foreign body is removed and antibiotics are administered.
VIII. Next steps
If vaginal discharge, bleeding, odor, or urinary tract symptoms continue after the foreign body is removed, a re-evaluation by a doctor is recommended.
Image source: Zhanku Hailuo
IX. Follow-up
If symptoms resolve after the foreign body is removed, follow-up may not be necessary.
If the doctor is not sure if the foreign body has been completely removed, or if a complicated condition (such as a secondary infection) is diagnosed when the foreign body is removed, a retest may be recommended.
X. Prevention
Vaginal foreign body-related infection prevention begins with good vulvar and vaginal hygiene.
Parents should teach young children to clean the perineum by wiping it from front to back. This reduces the amount of bacteria that can enter the vagina. Poor perineal hygiene can cause vulvar or vaginal irritation.
Parents can also prevent vaginal foreign bodies by talking to their children about the body and teaching the proper names of body parts.
Knowing the proper names of body parts allows children to better communicate problems, such as when children describe these body parts to adults when they have pain, discharge, or potential abuse.
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 6-8 hours.
Medications for vaginal infection or irritation should be prescribed by a doctor. Patients may often misjudge the cause of vaginal discharge. Cleaning the vagina does not require a vaginal douching or use of a vaginal wash, the douching will wash away Normal bacteria that help fight infection may increase the risk of infection.
Cleaning the vaginal area with showers and tubs can provide satisfactory cleaning results.
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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