Vaginal foreign body for contraceptive purposes resulting in vesicovaginal fistula in an unmarried nulliparous woman: a case report

Abstract

Introduction: Vaginal foreign bodies are an uncommon cause of vesicovaginal fistula (VVF). In resource-limited settings, modern contraceptive methods may be unavailable, and self-insertion of foreign bodies may be attempted as a form of contraception. This case highlights the urgent need for culturally sensitive, community-based sexual and reproductive health education to prevent harmful behaviors and their serious complications. Case presentation: A 28-year-old, unmarried, nulliparous woman presented to our facility with foul-smelling vaginal discharge and severe lower abdominal pain. Vaginal examination revealed a foreign body measuring approximately 10 × 6 cm, covering the cervix. The object was cylindrical, reddish, and made of plastic, with a firm consistency. Pelvic imaging confirmed the presence of a foreign body. Surgical removal was performed, followed by VVF repair, with restoration of continence. Discussion: The uptake of modern contraceptive methods is often limited by negative sociocultural influences. Inadequate or inaccurate sexual health education fosters myths and misconceptions, such as the belief that vaginal foreign bodies can prevent conception by blocking sperm. In certain cultural contexts, especially where discussion of contraception among unmarried women is stigmatized, individuals may resort to clandestine and unsafe practices, including intravaginal insertion of foreign materials. Although VVF is not typically life-threatening, it severely compromises quality of life through continuous urinary leakage, leading to physical discomfort, social stigma, psychological distress, and financial hardship. Conclusion: Community-based, culturally sensitive sexual and reproductive health education is essential to dispel misconceptions, encourage safe contraceptive practices, and prevent avoidable complications such as VVF.