We can’t talk about penises and urethras without mentioning vaginas. So, it seems like the perfect segue in my series on foreign bodies in the body to move directly from one family jewel to another.
So, let’s dive right in and open Pandora’s box, so to speak.
Our journey of exotic squatters assuming residence in the vaginal canal will involve an outside in approach, just as one would perform a medical examination. We will track the common culprits from childhood through adulthood. The former’s offenders tend to range from hygiene issues, curiosity and injury in the very young to the evolution of pubertal sexual discovery in adolescence. Once in adulthood, the relevance of inanimate objects in the vagina typically arises from sexual exploration or toy exploitation.
In the pre-pubertal set, coincident with the early stages of being potty-trained, toilet paper is the most frequent intruder. Toilet tissue is supposed to shred and fall apart after being flushed down the toilet, but vigorous wiping by kids can lead to pieces of tissue getting lodged inside the vagina. Presenting with malodorous discharge, discomfort or even bleeding (if really irritated), is often a parent’s or doctor’s clue. Infections can occur from poor technique as back-to-front wiping merely drags bacteria the wrong way. Education on proper wiping and hygiene is vital in this developmental stage.
Little kids will put anything anywhere and in any hole, albeit a nostril, ear or vagina. They are inquisitive. Playing with tiny objects in the bathtub, in particular, is not recommended because they get ‘lost.’ Where did that green marble go? Umm… it is hanging out with the crayons, legos and little lego men, action figures and - the most terrifying of all - watch batteries. These corrode and will cause a chemical burn which can erode vital surrounding tissue.
If a child is really cooperative, then some small items may be able to be removed by taking a tiny catheter and flushing it out in the office. The more challenging situations require anesthesia and a visit to the operating room to remove the foreign body.
According to Dr. Beth Rackow, gynecologist and infertility specialist at Columbia University Medical Center, there is “usually no long-term damage as the vagina heals quickly, so by the time you remove the foreign body, everything goes away.” Saddle injuries are frightening for a family and not a rarity in pediatrics, unfortunately. In Dr. Rackow’s experience, “Any kid can fall on any thing. It is usually better when it is a blunt injury like a balance beam as opposed to a piercing one where an object like a fence post or bars on a bicycle can impale and extend damage to the rectum, for example. With blunt injury, the fat pads or labia majora protect the more sensitive inner parts.” Trauma to the genitals can happen at any age.
Once puberty hits, retained tampons and condoms are standard fare. Teens (and many adults) often don’t realize that the vagina has a blind end and it is not a black hole with huge expanse where something can get lost. In this group, adolescents routinely are unwilling to self-investigate.
The inability to remove or place a tampon can often trigger a diagnosis of congenital anomaly (aka birth defect). With the first period, some may be able to put in a tampon, but - with enlargement upon blood saturation - be unable to dislodge it. This discovery can also occur upon first sexual encounter. These uncommon scenarios can prompt identification of misshapen or redundant tissue of the hymen or vagina.
The foreign body factor traditionally penetrates the adult sphere the most. Dr. Rackow has “coached many husbands and partners on how to get condoms and tampons out of their wife’s vagina. These are funny conversations as I have had to remind people there is an end to the vagina.” Apparently, many get unnerved by how deep they might have to go. It is important, however, that, once realized, the object needs to get out as there is a risk of toxic shock syndrome.
Where this issue comes to a head is the realization that everything the condom was supposed to do it isn’t doing anymore. With the sperm leaking out and oozing everywhere, pregnancy and infection prevention go awry. Honesty and introspection might play a role here. Consider if the size condom is appropriate for one’s member. Also, is it being correctly put on the penis? The climax of these choices might rest in happenstance as well.
Genital piercings don’t seem to be at the apex of the list of strange vaginal invaders. Nor, do bugs unless the intense perianal itching of pinworms extends to the external posterior vaginal area.
With the internet today and comparison with friends, many women are paying too much attention to whether their anatomy is or isn’t normal in appearance. They are presenting younger and younger to physicians requesting surgical correction to make the labia minora smaller when, in fact, there is a wide range of normal. True labial hypertrophy (aka overgrowth of one or both labia minora) may cause discomfort from chafing and rubbing especially with exercise or intercourse. Post-operatively, women can have soreness and swelling. There is also a risk of some lost sensation. Dr. Rackow refers women to the Great Wall of Vagina project where 400 women’s vulvas were cast in plaster and displayed as art to demonstrate the vast diversity of normal anatomy and endeavor to assuage anxiety.
Medical devices that migrate from their intended locations can intensify problems. A vaginal pessary is a rubber device positioned internally as an effort to hold everything in place when there is pelvic organ prolapse (aka sagging of the uterus, bladder, or rectum into the vagina). When used long-term, vaginal bleeding, pain, discharge and constipation can be side effects. IUDs (aka intrauterine devices) intended to prevent pregnancy should sit in place in the space within the uterine cavity. These can shift and get stuck in the wall of the uterus, for instance, which can lead to abnormal bleeding, scarring or pain.
When it comes to sexual play, foreign bodies in this orifice can catapult inward and upward. Battery operated vibrators are a mainstay, especially the small, bullet-shaped ones. They might be hard to grasp as they are slippery from natural and exogenous or commercial lubrication. Dr. Rackow advises her fertility patients to avoid certain lubricants that can be harmful to sperm - an obvious impedance to getting pregnant. It is also important that individuals don’t utilize household liquids intended for cleaning purposes, for example, as a substitute for lube. Dishwater detergent should remain focused on kitchenware, not vaginas. The soapy mess will irritate and possibly precipitate a greater chance of infection.
The vagina is a very resilient organ. Think about its original intent to stretch and push out a baby. This understanding, however, does not give unlimited license to test nature. Big risks might elicit big consequences. For example, hidden bags of illicit drugs have induced overdoses. Cold creams, dog toys and, basically, any object that is small, firm, hard and round can become interlopers sparking medical intervention.
Now that you know how to let lady flowers blossom, stay tuned for the next in the series on “Inanimate Objects in Orifices.” Will it be the colon? Check back to find out.