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Foreign Body in the Vagina

Vaginal Foreign Body


Presentation

  • We are presenting two case series of vaginal foreign body (VFB) in patients belonging to two different age groups. The literature review, summary of the two cases, and, the corresponding discussions will be presented.[ncbi.nlm.nih.gov]
  • Case presentation : A 10-year old pre-pubertal girl presented with malodorous vaginal discharge and continuous dribbling of urine per vaginum.[hoajonline.com]
  • Fifteen days later, the child presented again with similar complaints. On local examination, the tip of a safety pin could be visualized in the vagina [Figure - 1].[ijdvl.com]
  • Presentation 85-year-old female with gross hematuria Patient Data Age: 85 years Gender: Female Loading images... Possible kegel ball within the vagina with fibroid uterus and abnormal endometrial thickening concerning for endometrial carcinoma.[radiopaedia.org]
  • A 60-year-old postmenopausal woman presented with foul smelling purulent discharge per vaginum and stress incontinence. Speculum examination revealed foul smelling white discharge per vaginum and a friable vaginal wall which bled on touch.[casereports.bmj.com]
Foul Smelling Discharge
  • Pessaries sometimes irritate the vaginal tissues and cause a foul-smelling discharge. The discharge can be reduced by regular cleaning, nightly if possible.[merckmanuals.com]
Sputum
  • The symptoms that are highly suggestive of foreign body in the vagina are vaginal discharge , back weakness , pus in sputum , emotional symptoms , muscle swelling , pus in urine , abnormal size or shape of ear , and low back weakness , although you may[symcat.com]
Flushing
  • 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.[webmd.com]
Short Arm
  • Genitol Exomination Cindy Christian Joanne M Decker 971 Forensic Exominotion of the Sexual ASSoulf Victim 983 MonuCl Deforsion of the Testes 1003 Monogement of Zipper Injuries Joel A Fein Stephen Zderic 10 1015 Splinting Procedures Jean E Klig 1025 Short[books.google.com]
Muscle Swelling
  • The symptoms that are highly suggestive of foreign body in the vagina are vaginal discharge , back weakness , pus in sputum , emotional symptoms , muscle swelling , pus in urine , abnormal size or shape of ear , and low back weakness , although you may[symcat.com]
Altered Mental Status
  • Occasionally a foreign body may be left inadvertently in the vagina because of altered mental status.[emedicinehealth.com]
Vaginal Discharge
  • Once the object is removed and antibiotics are given, infection, fever, pain, and vaginal discharge should soon clear up.[webmd.com]
  • Within all the people who go to their doctor with foreign body in the vagina, 54% report having vaginal discharge, 22% report having pelvic pain, and 22% report having painful urination.[symcat.com]
  • Patients may commonly misdiagnose the etiology of a vaginal discharge. Douches or vaginal washes are not needed to clean the vagina.[emedicinehealth.com]
  • This usually leads to vaginal discharge or bleeding. It is more common for children, rather than adult women, to have foreign bodies in the vagina as this may be done out of curiosity.[cprcertificate.ca]
Foul Smelling Vaginal Discharge
  • All but three patients (91%) either recalled insertion of the foreign object and/or had vaginal bleeding or blood-stained or foul-smelling vaginal discharge, and/or visualization or palpation of the foreign body in physical examination.[ncbi.nlm.nih.gov]
  • While a variety of symptoms may result from a foreign body in the vagina, the most common symptoms are bleeding or foul-smelling vaginal discharge. Less common symptoms may include pain or urinary discomfort.[webmd.com]
  • A 22-year-old woman was brought to the gynaecology clinic because of foul-smelling vaginal discharge. On pelvic examination a ring-like foreign body was impacted between the anterior and posterior vaginal wall.[karger.com]
  • Symptoms Slight bleeding from the vagina Foul smelling vaginal discharge of yellow, pink or brown color.[punyahospitals.com]
  • While a variety of symptoms may result from a foreign body in the vagina, the most common symptoms are vaginal bleeding or foul-smelling vaginal discharge . Less common symptoms may include pain with urination ( dysuria ), or pelvic pressure.[emedicinehealth.com]
Vaginal Bleeding
  • However, symptoms of foreign body in the vagina may include: Vaginal discharge, typically with an unpleasant odour Pink, yellow to brown in colour Vaginal discomfort and pain Light vaginal bleeding Vaginal itching Pain during urination Pain during intercourse[cprcertificate.ca]
  • The presence of a foreign body may cause abnormal vaginal bleeding. If a foreign object was placed in the vagina and may still be there, the health care provider should be informed.[webmd.com]
  • The presence of a foreign body may cause abnormal vaginal bleeding . If a foreign object was placed in the vagina and may still be present, the health care professional should be informed.[emedicinehealth.com]
  • All but three patients (91%) either recalled insertion of the foreign object and/or had vaginal bleeding or blood-stained or foul-smelling vaginal discharge, and/or visualization or palpation of the foreign body in physical examination.[ncbi.nlm.nih.gov]
Vaginal Odor
  • Mycoplasma hominis, Ureaplasma urealyticum, Streptococcus viridans, and Atopobium vaginae have also been associated with BV. [1] Signs and symptoms Typical symptoms of BV include the following: Vaginal odor (the most common, and often initial, symptom[emedicine.medscape.com]

Workup

  • […] bacteria and assign scores to each as shown: Lactobacillus (score, 0-4) Bacteroides / Gardnerella (score, 0-4) Mobiluncus (score, 0-2) Total scores are calculated and interpreted as follows: 0-3: Normal 4-6: Intermediate bacterial count 7-10: BV See Workup[emedicine.medscape.com]

Treatment

  • What Is the Treatment for a Vaginal Foreign Body? The best management of a foreign body is removal. This is generally the only treatment necessary.[emedicinehealth.com]
  • It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.[drugs.com]
  • Visualization of the foreign body using a speculum and removal with a forceps may be the most efficient treatment.[webmd.com]

Prognosis

  • What Is the Prognosis for a Vaginal Foreign Body? Once the vaginal foreign body is removed, related symptoms of infection, pain, and discharge should quickly resolve.[emedicinehealth.com]
  • Prognosis Uncomplicated cases of bacterial vaginosis (BV) typically resolve after the standard antibiotic treatment. Mortality/Morbidity The prognosis for uncomplicated cases of bacterial vaginosis is generally excellent.[emedicine.medscape.com]
  • It needs to be differentiated from granulomatous lesions which have a much worse prognosis. A foreign body of plant origin may enter the genital tract due to self insertion, criminal abortion with an abortion stick, or possibly to uterine prolapse.[jpgo.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Int J Gynaecol Obstet . 1995 ; 50 : 193 -195 Genital foreign bodies are uncommon in prepubertal children, but this etiology should be considered when children present with genital discomfort, discharge, or bleeding.[pedsinreview.aappublications.org]
  • Overview Practice Essentials Bacterial vaginosis (BV), or nonspecific vaginitis, was named because bacteria are the etiologic agents and an associated inflammatory response is lacking.[emedicine.medscape.com]
  • Patients may commonly misdiagnose the etiology of a vaginal discharge. Douches or vaginal washes are not needed to clean the vagina.[emedicinehealth.com]

Epidemiology

  • Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983 Jan. 74(1):14-22. [Medline]. Schuyler JA, Mordechai E, Adelson ME, Sobel JD, Gygax SE, Hilbert DW.[emedicine.medscape.com]
  • This technique is described by, for instance, Willians, J G, et al, Nucl Acids Res, 18: 6531 (1990), and has previously been used not only to detect strain diversity, but also for gene mapping, population analyses, epidemiology and to analyse taxonomic[patents.google.com]
Sex distribution
Age distribution

Pathophysiology

  • Patient Education Educate patients regarding the basic pathophysiology, natural history, and risk factors of the bacterial vaginosis.[emedicine.medscape.com]

Prevention

  • Prevention Prevention of infections related to foreign objects in the vagina begins with good vulvovaginal hygiene. In young children, parents should instruct perineal cleaning by wiping front to back.[webmd.com]
  • DISCHARGE INSTRUCTIONS: Medicines: Antibiotics: This medicine will help fight or prevent an infection. Take your antibiotics until they are gone, even if you feel better. Hormone cream: This medicine may heal scratches or wounds in your vagina.[drugs.com]
  • How Do You Prevent a Vaginal Foreign Body? Prevention of infections related to foreign objects in the vagina begins with good vulvovaginal hygiene. In young children, parents should instruct perineal cleaning by wiping front to back.[emedicinehealth.com]
  • Episiotomy prevents excessive stretching and possible irregular tearing of the perineal tissues, including anterior tears.[msdmanuals.com]

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