Abstract :
Foreign body insertion into the vagina has been described across all ages. The presenting symptoms may be
persistent vaginal discharge, chronic pelvic pain, post menopausal bleeding. Foreign body as a differential
diagnosis is rarely thought of with the above presentations and remains a diagnostic challenge. An unusual
case of a foreign body causing vagina l stenosis, haematocolpos and inflammatory adnexal masses leading
to diagnostic confusion and difficult surgery is presented.
An eighteen year old unmarried woman with chronic pelvic pain of 3 years duration was diagnosed to
have bilateral adnexal masses on pelvic USG. On suspicion of genital tuberculosis she received a course
of anti tuberculosis treatment with no symptomatic relief or decrease in size of the adnexal mass. A
second sonogram four months later suggested presence of vaginal /cervical foreign body surrounded by
fluid (haematocolpos?) and she was referred to a gynaecologist. An MRI confirmed the findings. As
examination showed what was presumed to be a transverse vaginal septum the patient was posted for
examination under anaesthesia. There were dense vaginal adhesions and as the haematocolpos could not
be accessed from below a laparotomy was performed, the vagina opened from above and after draining
300ml of chocolate colored fluid a bottle cap was retrieved. The stenosed vagina was successfully opened
by vaginal dissection by abdomino-vaginal approach. This case is an unusual presentation of a foreign
body causing vaginal stenosis and causing much diagnostic dilemma and difficult surgery.
Keyword :
Foreign body, Vaginal stenosis, Vaginoscopy.