Foreign bodies in the vagina are objects that are inserted into the vaginal cavity, often for hygiene purposes, such as tampons, or for contraceptive purposes, such as sponges or vaginal diaphragms. Occasionally, they are inserted for sexual purposes.
They are a rare cause of vaginal and vulvar infection leading to recurrent or refractory vulvovaginitis, accounting for only 4% of cases in prepubertal girls. The differential diagnosis for recurrent vulvovaginitis due to a foreign body includes infections, congenital anomalies, trauma, allergic reactions, and/or dermatologic problems.
Symptoms typically include dark and malodorous vaginal discharge with purulent characteristics. It may be accompanied by intermittent bleeding, abdominal pain, urinary tract infection, and/or genital lesions. Possible complications include vaginal wall ulceration with fistula formation and infection.
Diagnosis is clinical and involves a focused interview and gynecologic examination to determine the presence of the foreign body. It may be necessary to collect cultures from the discharge to analyze the causative organisms of the infection.
Treatment includes removal of the foreign body, vaginal irrigation and, in some cases, antibiotics if an associated infection is suspected.
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