Cylindrical Alkaline Battery Causing No Harm to Vaginal Mucosa

We recently read the article by Griffin et al, “Vaginal burn from alkaline battery in 8-year-old” with great interest. The authors mentioned that tissue damage occurs because of leakage of potassium hydroxide, which has a strong alkaline content, from a button battery in such cases. They also concluded that prompt extraction of the battery is necessary to avoid serious morbidity. We agree with the authors in terms of extracting button batteries as soon as possible to avoid tissue injury in ingested or inserted cases. However, we believe alkaline leakage is more likely to occur in button batteries and cylindrical alkaline batteries might be less likely to cause vaginal tissue injury as corroborated in our following report. Recently we extracted a cylindrical alkaline battery from the vagina of a 5-year-old girl. She was suffering from vaginal discharge for 2 years. Before her admission, diagnostic procedures including vaginal swab cultures, rectal examination, and abdominal and pelvic ultrasonography were completed in another clinic and all were normal. Thus, we decided to perform vaginoscopy as a first-line diagnostic tool to evaluate the vaginal cavity. Vaginoscopy was performed using an ultra-thin pediatric cystoscope. Upon introducing the tip of the cystoscope we found an alkaline cylindrical battery filling vaginal cavity (Fig. 1). The battery was extracted using a curved hemostat. After extracting the battery, we re-evaluated the vaginal cavity. There was mild edema and minimal petechial lesions, which we attributed to chronic contact irritation.