Document Detail

Obstructive Uropathy and Vesicovaginal Fistula Secondary to a Retained Sex Toy in the Vagina.
MedLine Citation:
PMID:  24919434     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Vaginal foreign bodies (FBs) are a rare cause of vesicovaginal, rectovaginal, or urethrovaginal fistulae.
AIM: The aim of this study was to describe a rare case of vesicovaginal fistula (VVF) and obstructive uropathy and to review the literature.
METHODS: A case is presented. A comprehensive review of the literature was performed (1948-2013).
RESULTS: A 38-year-old woman presenting with sepsis, obstructive uropathy, and severe emaciation was found to have a sex toy retained in her vagina for 10 years. This had caused a VVF and bilateral hydroureteronephrosis. Bilateral nephrostomies were inserted and she underwent cystoscopy and examination under anesthesia (EUA) with retrieval of FB. A left ureteric stricture was demonstrated. Transabdominal VVF repair with omental flap and left ureteric re-implantation was performed. The VVF recurred, which was successfully re-repaired transvaginally. Seventy-six full text articles were reviewed. There were no previously published cases of VVF following vaginal sex toy insertion. There are four cases of obstructive uropathy secondary to a vaginal FB in the literature: three pessaries and one plastic cap. There are 44 cases of VVF secondary to FB: 22 plastic caps (typically from aerosol bottles, inserted for masturbation or contraception) and 5 pessaries. At least nine were in girls aged ≤18 years. Average presentation is 15 months (range 2 months to 35 years) after FB insertion. Most cases were managed with surgical repair; predominantly transvaginal.
CONCLUSIONS: This case describes an extremely rare but potentially life-threatening case of obstructive uropathy caused by a chronically retained sex toy, and adds to the list of potentially rare causes of a VVF and obstructive uropathy. We advocate urinary diversion, staged removal of FB, upper urinary tract imaging, and EUA with VVF repair and/or ureteric reimplantation if required. Transvaginal is the preferred access for FB-associated VVF repair without concomitant ureteric reimplantation. Donaldson JF, Tait C, Rad M, Walker S, Lam TBL, Abdel-Fattah M, and Swami SK. Obstructive uropathy and vesicovaginal fistula secondary to a retained sex toy in the vagina. J Sex Med **;**:**-**.
James Fergus Donaldson; Campbell Tait; Marcel Rad; Shonagh Walker; Thomas B L Lam; Mohammed Abdel-Fattah; Satchi Kuchibhotla Swami
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-12
Journal Detail:
Title:  The journal of sexual medicine     Volume:  -     ISSN:  1743-6109     ISO Abbreviation:  J Sex Med     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101230693     Medline TA:  J Sex Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 International Society for Sexual Medicine.
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