Vagina

An extraordinary variety of bizarre foreign bodies have been pencils and small jam jars. The
patient is often mentally retarded or a young child, and in both these a persistent and a
malodorous discharge should always suggest the presence of a foreign body. Neglected or
forgotten objects employed therapeutically. The most frequently found is the ring pessary
used in prolapse. Some of these have remained in the vagina for many years and have
become encrusted with phosphatic deposits. These neglected pessaries can cause severe
ulceration of the posterior fornix and later vaginal carcinoma. Less traumatic are forgotten
swabs and tampons which cause a foul purulent discharge. Contraceptive devices such as
cervical caps and diaphragms, even a mislaid condom when retained, can cause discharge
and ulceration. Instrumental damage is caused during attempted criminal abortion. Sound,
gums, elastic bougies, knitting needles and the like have caused perforation of the vagina
into the bladder, rectum, pouch of Douglas and the parametrium. Very rarely, a needle can
break during suturing of an episiotomy and a piece may remain there without causing
symptoms. This is accidentally discovered during a subsequent confnement. Obstetric
cervical tear occurs during precipitate labour or instrumental delivery. The commonest
cervical tear occurs during cervical dilatation with the metal dilator and this causes bleeding
and later an incompetent os. Cervical stenosis follows conization and amputation as in
Fothergill operation for prolapse and cauterization of cervix for cervical erosion. This can
lead to haematometra and infertility

Treatment
Treatment of vaginal foreign bodies is to remove them, if necessary, under anaesthesia.
Simple local Antiseptic douches are suffcient for after treatment. If, however, the vagina has
been perforated, chemotherapy is indicated, and if there are signs of peritoneal infection or
bowel damage, as with criminal abortion, laparotomy is needed