Genital foreign bodies are uncommon in prepubertal children, but this etiology should be considered when children present with genital discomfort, discharge, or bleeding. Several case series have reported that 4%to 5% of all prepubertal girls who present with genital complaints will have a vaginal foreign body. The symptoms vary. Vaginal bleeding is the most sensitive and specific symptom of a foreign body; 93%of patients who have a vaginal foreign body present with spotting,bleeding, or blood-tinged discharge,and 82% of patients who exhibit vaginal bleeding have a vaginal foreign body. Discharge, which often is greenish or blood-tinged and frequently foul-smelling, is much less common (18% of patients). Symptoms may be of long-standing duration (case reports have described symptoms lasting several years)and are refractory to all treatment modalities, including antibiotics or improvements in hygiene, unless the foreign body is removed.

The most common foreign body in the prepubertal girl is toilet paper. However,...

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