How to treat vaginal pain caused by vaginal foreign bodies

Vaginal abnormalities mostly occur in infants or children. They have no ability to distinguish and will play with things indiscriminately, which may cause them to put foreign objects into the vagina. As for adults, it occurs in women who masturbate. Vaginal pain caused by foreign objects in the vagina is very normal. If the foreign objects can be removed in time, the pain can be recovered after a few days of rest. However, if the foreign body is not removed, more serious harm will occur. How to treat vaginal pain caused by vaginal foreign bodies?

The vagina is an elastic muscular lumen with a wider upper end than the lower end. The vaginal mucosa has many transverse folds and the front and back walls are usually tightly attached. Therefore, once a foreign body enters the vagina, it is difficult for it to fall off on its own.

1. Removing foreign bodies The methods for removing foreign bodies vary slightly depending on the patient's age and the size, location, and shape of the foreign body:

(1) Vaginal removal: Older children can insert their fingers into the vagina to hook out the foreign body, or use a small speculum to directly visualize the foreign body with forceps. Adults can directly remove the foreign body under direct visualization of the speculum. Emge reported the successful removal of a vaginal foreign body: an orange, using forceps. When removing sharp foreign objects, the long axis of the foreign object should be parallel to the longitudinal axis of the vagina, and the sharp end of the foreign object should be facing the vaginal opening to prevent damage to the mucosal tissue.

(2) Rectal examination and displacement method: In young children, under the guidance of the rectal examination finger, hemostatic forceps or a small scraper can be inserted into the vagina to push out the foreign body.

(3) Nasal endoscope: Use a nasal endoscope to dilate the child's vagina, and use forceps to remove foreign objects. If the child cannot cooperate, intravenous ketamine anesthesia can be used. The stem of the nasal endoscope is about 3 cm long and can reach the lower part of the vagina. Under 1% tetracaine (dicaine) surface anesthesia, the nasal endoscope is used to dilate the vagina, and then a small scraper is used to remove the foreign object. Removing the foreign object with an oval forceps is simple and convenient, does not cause damage, and is easy to promote and use in primary hospitals.

(4) Removal of foreign bodies under direct hysteroscopy: Because the nasal endoscope is short and has no light source, it is sometimes difficult to achieve the purpose of diagnosis and treatment. There are reports of using hysteroscopy to remove foreign bodies from the vagina of young girls: During the operation, local mucosal anesthesia is required and a 1% tetracaine cotton pad is applied to the vaginal opening, and microscopic examination is performed 5 minutes later. Take the lithotomy position for the bladder and disinfect the vulva routinely. Add 160,000 U of gentamicin to 500 ml of 5% glucose solution to flush the vulva. Slowly insert the hysteroscope coated with lubricant into the vagina. Then use the left thumb and index finger to hold the cotton ball to compress the vulva to prevent the outflow of fluid and make the vagina swell. Comprehensively observe the pathological changes under direct vision of the hysteroscope and perform necessary treatment according to the condition, such as removing foreign bodies, taking biopsy, flushing and applying medicine, etc.

(5) Microcolposcopy: Parker reported in 2000 that a small-diameter trocar sheath plus a 2-3 mm endoscope, with saline as the uterine distention fluid, could be used to view the entire cervix and vagina to detect small foreign bodies such as colored crayons and to treat them under direct vision. It is used for the diagnosis and treatment of vaginal diseases in prepubertal children and is simple to operate.

The treatment of vaginal pain caused by vaginal foreign bodies will not recur as long as the foreign body is successfully removed. The removal of foreign bodies should be judged based on the patient's age, the size of the foreign body and the location of the foreign body. Some patients push foreign objects deep into the vagina, making them very difficult to remove and necessitating surgery, which can cause even more serious injuries to the patient.