Abstract

Background: A neglected foreign body in a vagina leading to vesico-vaginal fistulae in young girls is a very rare presentation. As such, it poses significant therapeutic challenges in its management.

Case presentation: A 10-year old pre-pubertal girl presented with malodorous vaginal discharge and continuous dribbling of urine per vaginum. Two separate stones, one each in the vagina and the urinary bladder, with concomitant vesico-vaginal fistulae (VVF) were diagnosed. The history of a foreign body (the cap of a nail paint bottle) inserted into the vagina, while playing, about two years back was elicited. She underwent abdomino-vaginal repair with satisfactory outcome.

Conclusion: Vaginal foreign bodies leading to stone formation and subsequent VVF are a rare presentation. Till date 12 such cases have been reported. This case is being reported to highlight this rare cause of VVF in young girls and to develop consensus regarding its management. The procedure of management here involved first removal of the vaginal foreign body and then prolonged catheterization followed by subsequent repair of VVF after 6-8 weeks. However, individualization of such cases may be required depending upon specific characteristics (e.g., large size in index case).

Keywords: Vesico-vaginal fistulae, foreign body vagina, pre-pubertal girl