Foreign body retrieval

Alternate title: things I've had to remove from vaginas

1. I get consulted by the hospitalist on a young woman admitted for something that hospitalists take care of because her CT shows a foreign body in her vagina. I go talk to her, she has not idea what it could be, so it's time to investigate. Digital vaginal exam reveals a soft foreign body, I remove it and inspect it (prior to triple bagging it in biohazard bags) and I say "it's a..... makeup sponge?" At this point the patient goes "ooooohhhhhhhh" and I knew I was in for a good story.

She tells me "so my friend, who is a prostitute, says that if you want to have sex while you're on your period, just put a makeup sponge in there and it'll block the blood without getting in the way, and I guess I just forgot to take it back out." LMP was 3.5 weeks ago, btw.

We had a good laugh about it, and I advised her to make better friends.

1. An established patient of mine calls the office in the middle of the day in desperation because she has a vibrator stuck in her vagina and she can't get it out. I of course tell her to head straight to the office and I'll take care of it. She arrives a while later, I do a pelvic exam and she has a small, hard plastic bullet vibrator (purple, for those wondering) stuck sideways in her posterior fornix, pinned by her cervix against the back wall of her vagina. I tried to grab it with ring forceps to no avail, but when the metal forceps touched it they buzzed, because the damn thing was still running! I gave up on trying to grab it with the rings and was able to grab it digitally, much to her relief.

This poor woman had to drive herself a little over an hour with this STILL POWERED UP vibrator stuck in her vagina so that I could retrieve it. I cannot imagine the discomfort.

I offered to give it back to her and she declined, so we pitched it.

And lastly, I see a new patient in the office who was referred to me by her PCP for "CT shows tampon in vagina". She has no complaints, the CT was done 5 days prior for unrelated reasons, etc. She tells me "it must have been in there for a while".

So let's look for it. I look in every possible corner of her vagina. I use 3 different specula trying to find this thing. Nothing. I do a digital examination, can't find this thing anywhere. There is no tampon. So I step out and pull up the actual CT films myself. They show what looks like a super tampon right in the mid vagina, and you can even see the string tracking all the way to the introitus. So I go back in and talk to the patient and this time she tells me that she actually just finished her period he other day.

Her PCP sent her to me because her tampon, that she uses while on her menses, was in her vagina while she was menstruating. There was never a retained tampon, just a failure of clinical correlation. Actually now that I think about it, the radiologist did not write "clinical correlation recommended", so how could the PCP have known to do so???

Bonus foreign object. Not my case, but one of our ER docs once fashioned a makeshift vacuum extractor by cutting the dome off of a nasal bulb suction, hooking it to wall suction, and basically doing a vacuum assisted vaginal delivery of a pool ball. I think it was the 7 ball.

Author: justpracticing