Large vesico-vaginal fistula caused by a foreign body

Abstract

Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

Endoscopic Treatment of a Severe Vaginal Stenosis Following Battery Insertion in an 11-Year-Old Girl

“…In the literature, no report currently exists regarding fistula formation after battery vaginal insertion, but it is biologically plausible to have similar complications in the vagina. 11 …”

Disk Battery as a Vaginal Foreign Body in a Five-Year-Old Preadolescent Child

“…While vesicovaginal fistulas occasionally can occur secondary to underlying malignancies, they rarely take place secondary to vaginally inserted FBs [9]. Nonetheless, several cases of vesicovaginal fistulas have been reported in literature among adults (more than 18 years old) [10][11][12][13].…”

Large Urethro-Vesico-Vaginal Fistula due to a Vaginal Foreign Body in a 22-Year-Old Woman: Case Report and Literature Review

“…Vesico-vaginal fistulas are treated with both delayed transvaginal (11/29) and transabdominal (10/29) approaches. Where available, success rates seem to be high: in the 6 unsuccessful cases reported in the literature, all patients were successfully retreated (table 1) [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28]. Pushkar et al [2], moreover, showed a success rate of UVF treatment of 90 and 98% at primary and secondary treatment, respectively; 52% of the patients developed stress urinary incontinence, which was successfully treated with sling procedures.…”

“…Foreign bodies may be inserted during sexual intercourse or masturbation [5], with contraceptive purposes [6], as neglected pessaries [7] or, rarely, during rape or as punishment [8]. …”