Multidisciplinary Surgical Management of a Long-Retained Vaginal Foreign Body in an Adolescent with Complex Psychosocial History: A Case Report.

BACKGROUND

Retained foreign bodies can be the source of prolonged vaginal bleeding or abnormal discharge in pediatric patients.

CASE: A 17-year-old with history of childhood sexual abuse presented with a six-year course of progressive, foul-smelling vaginal discharge. Despite multiple provider visits, a pelvic exam had never been completed until referral to specialized care. An exam under anesthesia demonstrated significant adherence of the object and imaging failed to clarify the planes of invasion. Therefore, a multidisciplinary surgical team was convened for further evaluation. Laparoscopy was utilized to confirm no pelvic invasion, and the 8 cm object was removed vaginally.

CONCLUSION

Long-retained vaginal foreign bodies can be significantly morbid. The value of trauma-informed care, the need for early exams, and a multidisciplinary approach are invaluable for patients presenting with these symptoms.