Registered nurses who have completed sexual health competency accreditation can undertake removal of a foreign body from the vagina.

Clients with a foreign body in the rectum or urethra are to be referred to the nearest emergency department for assessment.

Consider need for STI and HIV tests based on risk assessment.

Patients are managed according to procedure outlined.

Common objects that may be found in the vagina are:

• tampons: women sometimes forget they are there at the end of menstruation, or insert one whilst another is still in the vagina
• condoms or pieces of condom retained during intercourse
• contraceptive device e.g. sponge, cap
• sex toys.

Some women present with complaint of vaginal odour (with or without a discharge); others will be unaware of the retained product but it is visible on speculum examination.

Some objects, in particular tampons that have been retained for some time, can have an offensive odour. Ensure that when the foreign object is identified, in particular a retained tampon, preparation for removal is carried out.

Assemble:

• speculum and lubricant
• container with enough water to submerge object, sponge-holding forceps, plastic bag for disposal.

Insert speculum, visualise object, insert sponge-holding forceps, grasp the object and remove, quickly submerge in container of water.

When possible and appropriate, remove object to plastic bag, secure and dispose of in clinical waste.

After removal of the retained object, most clients require no further follow-up, but should be advised to monitor discharge. If they experience symptoms (fever, pain, vaginal odour, rash, swelling or discharge) they need to see a doctor for review and possible treatment.

Document presence of vaginal foreign body and type, noting any changes to vaginal environment, e.g. inflammation, discharge, colour, lesions, discomfort.

1. eMedicineHealth. Foreign body, vagina. WebMD, Inc.; 2018. Available at: https://www.emedicinehealth.com/foreign_body_vagina/article_em.htm#vagina_foreign_body_facts