Sometimes an object (also known as a ‘foreign body’) can become stuck in the vagina, or you may simply forget it is there. Common objects that may get stuck include tampons, condoms (or pieces of a condom if it has split), a contraceptive device (such as a diaphragm or sponge), or something inserted for sexual pleasure, such as a sex toy. Show It is important for the object to be removed as soon as possible. If you have tried to remove it but failed, you should consult a health professional as soon as possible. Retained tamponA tampon is ‘retained’ when the tampon has been inserted but later becomes either stuck or ‘lost’. Reasons for this may include:
The vagina is quite elastic so it is possible to have sex or insert a second tampon while one is still inside. In these cases, the tampon can turn sideways so the string gets drawn in and it becomes difficult to remove. When a woman forgets to take a tampon out at the end of her period it can become lodged at the top of the vagina, next to the cervix. The string may still be noticeable. A tampon cannot get lost in the abdomen. The cervix is at the end of the vagina and only has a tiny opening to allow blood or semen through. Damage cannot be caused to the vagina or cervix by using a tampon. The main concern with a retained tampon is an infection or toxic shock syndrome (TSS), but this is very rare. Signs of a retained object or tamponSigns that you may have a retained object in your vagina include:
Removing a foreign body or tamponYou should not attempt to remove a large, delicate or fragile object because you may damage your vagina. Instead, visit your doctor or emergency department as soon as possible. If you have a foreign object in your vagina, or you have lost a tampon or it has become stuck, and you have none of the symptoms listed above, you may want to try removing it carefully yourself. Never try to remove an object with another object. You could damage yourself or develop an infection. First, make sure your hands are thoroughly washed before you try to remove anything because this will stop any outside bacteria from entering your vagina. If you have any scratches or cuts on your hands, make sure these are covered. Sit on a toilet with your feet resting on something that is about 30 centimetres high and push as if you are trying to have a bowel movement or pushing out a baby. This might help push the object down. After that, insert one finger into your vagina and reach in as far as possible, making circular and back and forward movements. Try to feel the area at the top of your vagina because this is where items like tampons often get stuck. If you feel the object, remove your finger then place 2 fingers into the same area, trapping the object between them, then try pulling it out gently. When to get helpYou should visit your doctor or practice nurse if you cannot easily remove the object yourself or if you are worried about whether or not you have put an object in and forgotten about it. You should also visit the doctor if you have a retained object and symptoms that suggest an infection such as a fever, pain, swelling or redness. An object should be removed as soon as possible, especially if a tampon or a large or delicate object is stuck (for example, something sharp or made from glass). If a fragile object breaks, do not try to remove it any further — go to your nearest emergency department immediately. FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services. ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist. For further advice, you should contact your doctor or call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria). Do not be embarrassed. Remember, the doctors and nurses have assisted women in a similar situation before. Last reviewed: February 2022 What Is It? Pelvic organ prolapse (POP) occurs when one or more organs in your pelvis—your uterus, vagina, urethra, bladder or rectum—shifts downward and bulges into or even out of your vaginal canal. Pelvic organ prolapse (POP) occurs when one or more organs in your pelvis—your cervix, uterus, vagina, urethra, bladder or rectum—shifts downward and bulges into or even out of your vaginal canal.. Just one symptom that can be associated with the condition—urinary incontinence—costs the country more than $20 billion annually in direct and indirect medical costs, while surgeries to correct POP cost more than $1 billion annually. Approximately 200,000 surgeries are done each year in the United States to correct POP. The condition is poised to become much more common in the United States and other Western countries with the aging of the Baby Boomers (women born between 1946 and 1964). In fact, an estimated 11 percent to 19 percent of women will undergo surgery for POP or urinary incontinence by age 80 to 85, and 30 percent of them will require an additional surgery to correct the problem. Many women don't have any symptoms of POP. These fortunate women need not do anything but preventive nonsurgical treatment, such as lifestyle options. Those who do have symptoms may experience a feeling of vaginal or pelvic fullness or pressure or feel as if a tampon is falling out. They may also experience incontinence, inability to completely empty the bladder, pain in the pelvic area unrelated to menstruation, lower back pain and difficulty getting stools out. Some women also complain of not being able to fully void stools and of fecal soiling of their underwear. Treatments include lifestyle options, such as exercises to strengthen the pelvic floor, devices designed to support the pelvic organs, physical therapy and surgery to repair or support damaged ligaments and reposition the prolapsed organs. For women not planning to have sex, obliterative surgeries, which close the vaginal opening, are also an option. Risk factors for POP include pregnancy (particularly pregnancies that have ended with a vaginal birth, especially a forceps-assisted birth), genetic predisposition, aging, obesity, estrogen deficiency, connective tissue disorders, prior pelvic surgery and chronically increased intra-abdominal pressure from strenuous physical activity, coughing or constipation. In many cases, women with POP have at least two or more risk factors. Having been pregnant with and given birth to a child—particularly two or more children—is a significant risk factor. According to the National Association for Continence, as many as 50 percent of women who have ever given birth have some degree of POP. While cesarean section delivery reduces the risk of POP and urinary incontinence, there is still no good evidence to support elective cesarean sections for preventing POP. Having a hysterectomy may also increase your risk of POP, depending on how the surgery was performed and how well the surgeon reattached the ligaments that typically hold up the uterus to the top of the vagina, where the cervix used to be. Genetic factors also contribute to your risk of POP. If possible, talk to your mother, grandmother, aunts and sisters about any pelvic organ problems they've had. Also ask about urinary and fecal incontinence; although it's embarrassing to talk about, both are often associated with POP. The most common symptoms associated with pelvic organ prolapse (POP) are related to urination. You may have feelings of urgency, in which you suddenly have to urinate, find yourself urinating more often than normal, experience urinary incontinence or have difficulty urinating and completely emptying your bladder. Some women experience sexual dysfunction, such as problems reaching orgasm and reduced sexual desire or libido. Although prolapse does not directly interfere with sexuality, it may affect self-image. Data shows that women with urge incontinence have the most problems with sexuality and that urge incontinence interferes with sexuality more than any other form of incontinence. Some women avoid sex because they are embarrassed about the changes in their pelvic anatomy, and some worry that having sex will "hurt" something or cause more damage. Nothing could be further from the truth. Intercourse exercises the pelvic floor muscles and replaces the prolapsed organs to their appropriate position. It does not cause any damage and, for most women, when their partner is on top, the prolapse is not visible. You may also experience problems in the rectal area. Some women with POP have pain and/or straining during bowel movements, and some experience anal incontinence, in which they inadvertently release stool. Other symptoms include feeling as if a tampon is falling out. In fact, if the cervix has descended into the vagina, you may find you can't use a tampon at all. However, doctors may have trouble diagnosing the condition because many symptoms can be related to situations and medical conditions unrelated to POP. The following questions can help alert your doctor to the possibility that you may have POP:
Let your doctor know if you answered yes to any of these questions. Diagnosing POP begins with a complete medical history and physical examination. The doctor will carefully examine your vulva and vagina for any lesions, masses or ulcers and will perform an internal examination to identify any prolapsed organs. The doctor will also conduct a rectal examination to test for the resting tone and contraction of the anal muscle and to look for any abnormalities in that region. The doctor may also examine you while you're standing (to see if gravity brings the organs down) and may ask you to strain as if you were urinating or having a bowel movement. A check of the nerves and reflexes in this area may be included. POP refers to a displacement of one of the pelvic organs (uterus, vagina, bladder or rectum). These displacements are typically graded on a scale of 0 to 4, with 0 being no prolapse and 4 being total prolapse (called procidentia). Your doctor will determine which type of prolapse you have. The different types include the following:
Tests Your doctor may order several tests to confirm a diagnosis of POP. These include:
If you have problems with bowel movements, your doctor will likely refer you to a gastroenterologist for a thorough evaluation, including a colonoscopy to rule out colon cancer, which can cause constipation and straining. Pelvic organ prolapse (POP) is not a dangerous medical condition. Treatment options range from doing nothing and observing your condition over time to surgery to correct the prolapse. The choice of treatment typically depends on how your POP affects your quality of life, on your overall health and on your physician's expertise. Nonsurgical options
Surgery An estimated 11 percent to 19 percent of women will undergo surgery for POP or urinary incontinence by age 85, and 30 percent of these women will require an additional surgical procedure. The goal of surgery for POP is to improve your symptoms by addressing the underlying cause. Surgery can be reconstructive, which corrects the prolapsed vagina while maintaining or improving sexual function and relieving symptoms, or obliterative, which moves the organs back into the pelvis and partially or totally closes the vaginal canal. Surgery may involve repairs to any pelvic organs, including the various parts of the vagina, the perineum (the region between your vagina and anus), bladder neck and anal sphincter (anus). The goal of surgery is to reposition the prolapsed organs and secure them to the surrounding tissues and ligaments. Although hysterectomy is still commonly performed in women with symptomatic POP, several other surgical procedures are available. Which your doctor recommends depends on your condition and the specific type of prolapse. Surgeries can be performed through an abdominal incision, vaginally or laparoscopically, with or without robotic assistance, through small incisions in your belly. Studies find that the vaginal or laparoscopic approach results in fewer wound complications, less postoperative pain and shorter hospital stays than with open abdominal surgery. Today, a large number of POP surgeries are performed vaginally, laparoscopically or robotically. However, all forms carry a risk of relapse. In terms of the surgery itself, procedures vary depending on the type of prolapse. In most cases, surgery for POP is performed under general or regional anesthesia (epidural or spinal), and patients may stay in the hospital overnight. Here's an overview of the surgical procedures used to treat the various forms of POP:
Preventing pelvic organ prolapse (POP) begins in your teens. Get in the habit of practicing Kegels or pelvic tilts as done in yoga several times a day, until doing them becomes as routine as brushing your teeth. When you get pregnant, make sure you're aware of the risks and benefits of a forceps delivery in case one is necessary. A forceps delivery creates a very high risk for incontinence and prolapse. Talk to your health care professional about the options of a vacuum delivery or a cesarean section. Maintaining a healthy weight and quitting smoking may also help prevent pelvic floor problems, including POP. You should also avoid straining during bowel movements and when lifting heavy items, and if you have a chronic cough, get it checked out. Chronic coughing creates the kind of straining that can lead to POP.
Review the following Questions to Ask about pelvic organ prolapse (POP) so you're prepared to discuss this important health issue with your health care professional.
For information and support on coping with Pelvic Organ Prolapse, please see the recommended organizations, books and Spanish-language resources listed below. American Association of Gynecologic Laparoscopists (AAGL) Phone: 714-503-6200 American College of Obstetricians and Gynecologists (ACOG) Email: |