Vaginal foreign bodies are not uncommon in clinical practice and can occur at any age. They are common in young girls in China; they also occur in adult women abroad. The main manifestations of vaginal foreign bodies are increased vaginal discharge and infection; improper retention or disposal of foreign bodies in the vagina can lead to vaginitis, vaginal adhesions, foreign body encapsulation, displacement, and even perforation. Due to the lack of cognitive ability of young girls and limited gynecological examination, the diagnosis and treatment are often not timely, and it is easy to miss the diagnosis and misdiagnosis, which brings great mental and physical pain to the children. Diagnosis: 1. History of foreign body inserted into the vagina, or history of suspected foreign body in the vagina. 2. Clinical manifestations are increased vaginal discharge, which is purulent, watery and smelly. The diagnosis can be made by vaginal examination in women with a history of sexual intercourse. 4. If necessary, B-ultrasound, X-ray, CT and other auxiliary examinations should be performed. 5.Usually there are no signs or symptoms of systemic infection. Local inflammation of the genital tract can be diagnosed by smear of secretions, culture or PCR. Some small and soft non-metallic foreign bodies in young children are more difficult to diagnose, and pediatric colposcopy is used abroad to confirm the diagnosis. In China, there are no special instruments for pediatric vaginal examination, but nasoscopes and small fiber hysteroscopes are often used instead. Laboratory tests 1. Smear of vaginal secretions: look for Trichomonas, Candida and other pathogenic microorganisms to determine the type of infection. Vaginal foreign bodies are prone to co-infection and vaginal discharge smear can help in diagnosis and treatment. 2.Vaginal exfoliative cytology: to assist in the diagnosis of inflammatory response and to exclude malignant tumors, such as cervical and vaginal chylosarcoma in infants and children should be excluded. Methylene blue test: The purpose is to identify vesicovaginal fistula, cervicovaginal fistula or ureterovaginal fistula and to help identify very small fistulas of unknown location. The method is to inject 200ml of diluted methylene blue solution into the bladder via the urethra and if blue liquid is seen spilling out through the small holes in the vaginal wall, it is a vesicovaginal fistula; blue liquid coming out through the external cervical opening is a vesicocervical fistula; clear urine coming out of the vagina indicates that the urine is from the kidneys and is a ureterovaginal fistula. Other auxiliary examinations 1. X-ray radiography: depending on the nature of the foreign body, opaque shadows are sometimes visible. 2.Cystoscopy: It can understand the situation inside the bladder, the presence of stones, inflammation, especially the location and number of leaky holes. 3.Vaginal irrigation: commonly used in young girls or teenage girls, vaginal irrigation not only improves the vaginal environment and facilitates the treatment of vaginitis, but also small foreign bodies can be flushed out of the vagina for a clear diagnosis. 4. intravenous pyelogram: to understand the function of bilateral kidneys and whether there is any abnormality of ureter, and it is used to diagnose ureterovaginal fistula. Differential diagnosis 1, vaginitis vaginal foreign body increased discharge, should be distinguished from bacterial, trichomonas and candida vaginitis trichomonas leucorrhea is yellow foamy, candida is tofu-like and the main symptom is vulvar itching, through speculum examination and vaginal secretion examination can help diagnose. 2, vaginal pinworm infection is common in young girls, with severe itching, vulvar skin, especially around the anus can appear dermatitis and scratch marks, vaginal secretion smear inflammatory reaction is light; transparent adhesive paper anal test method can be seen pinworm eggs. 3. Malignant tumors of the reproductive system should be differentiated from malignant tumors when vaginal discharge is malodorous, such as vaginal rhabdomyosarcoma in young girls and endodermal sinus tumor in young girls can be diagnosed by ultrasound, CT, MRI, serum methemoglobin measurement and biopsy. Treatment options 1. Removal of foreign body The vagina is a flexible muscular cavity, the upper end is wider than the lower end, and there are many transverse folds in the mucosa of the vagina, which are usually close to the front and back walls. The method of foreign body removal varies slightly according to the patient’s age, the size, location and shape of the foreign body, the length of time the foreign body remains in the vagina and the degree of inflammation. (1) Anal nudge method: Young children can use hemostatic forceps or small scrapers to reach into the vagina and push out the foreign body under the guidance of anal fingers. The sharp foreign body should be removed so that the long axis of the foreign body is parallel to the longitudinal axis of the vagina and the sharp end of the foreign body faces the vaginal opening to prevent damage to the mucosal tissue. (2) Removal of foreign body under direct hysteroscopy: It is sometimes difficult to achieve the purpose of diagnosis and treatment because of the short nasoscope and the absence of light source. Under direct hysteroscopy, the pathological changes are observed comprehensively and the necessary treatment, such as removal of foreign bodies, biopsy, irrigation and drug application, is performed according to the condition. (3) Vaginal irrigation: A urinary catheter can be inserted into the vagina and the vagina can be repeatedly irrigated with 1/5000 potassium permanganate solution or 1% iodine volts under pressure. Sometimes small foreign bodies such as grit, paper dust and wheat grains can be flushed out by the irrigation solution and have anti-inflammatory effects. (4) Nasoscopy: Dilate the vagina of young children with a nasoscope and remove the foreign body with forceps. (5) Micro colposcopy: It is used for the diagnosis and treatment of vaginal diseases in prepubertal children, which is simple to operate, less damaging and easy to accept. 2. Local treatment After removal of foreign body, it should be treated routinely as vaginitis. 3.Vaginal surgical repair Anyone with urinary fistula and fecal fistula formation needs surgical repair.