Abstract
Vaginal foreign bodies (VFBs) can affect women of all ages, but they are most frequently observed in the pediatric population. Such cases are relatively uncommon in women of reproductive age and postmenopausal women, and the long-term retention of foreign bodies in adults is particularly rare. We report a case of a 53-year-old postmenopausal woman with a history of bipolar disorder and autism spectrum disorder who presented with persistent vaginal bleeding, discharge, and foul odor for one year. She admitted to inserting various objects into her vagina annually since her early 30s. Imaging (ultrasound and CT) revealed multiple hyperechoic structures within the vaginal canal. Hysteroscopic examination demonstrated extensive inflammatory hyperplasia and polypoid lesions. A total of 13 foreign bodies, including porcelain bottles, a button, medicine bottles, and candy wrappers, were successfully retrieved. Postoperative histopathology confirmed benign inflammatory changes, ruling out malignancy. The patient recovered uneventfully. This case highlights the diagnostic challenges and management of long-term retained VFBs in postmenopausal women with psychiatric comorbidities. It underscores the need for a high index of suspicion in such patients presenting with non-specific gynecological symptoms to prevent severe complications.