Foreign Bodies of the Vagina (Discharge, Genital Bleeding)

Parts of a collection of toys of a 9.4-year-old girl; the game pawn on the right side has lost its color. The object on the left side is a stained plastic pin from a pin board. The patient has a chronic malodorous discharge from the vagina. The diagnosis is foreign bodies from the vagina. Foreign bodies are introduced by toddlers or by their play-mates during doctor games and may remain there for a long time until the girls are presented to a general practitioner due to intermittent genital bleeding, bloody discolored spots on the panties, or a malodorous discharge from the vagina. Relatively frequent foreign bodies are toilet tissues and tampons in teenagers. Finally, the examiner may detect swabs that were left during an earlier endoscopy. Inspection of the external genitals, rectal palpation, and ultrasound of the abdomen including the vagina are not always diagnostic; therefore, a cystocolposcopy should be performed in urgent suspicion of foreign body; in addition, this examination which is performed in general anesthesia allows a non-traumatic removal of the foreign body and an inspection of the vulva and vagina.