• 4-5% of Prepubertal Vaginal Complaints are the result of foreign body.
• Vaginal bleeding is the most sensitive (93%), and specific (82%)
• Discharge usually foul-smelling is only seen in 18% of patients
• Undiagnosed symptoms may be chronic, (case reports lasting years).
• Complications of delayed removal include infection, toxic shock syndrome, fistulas, adhesions and even infertility
• Exam in knee chest position, and removal with irrigation or tissue forceps.
• Failure to remove FB may require exam under anesthesia.

References

1. Di Meglio. "Genital Foreign Bodies," Pediatrics in Review.  1998; (19) 34.
2. Paradise, J. Willis, E.  Probability of Vaginal Foreign Body in Girls with Genital Complaints, MD; Am J Dis Child. 1985;139(5):472-476