Scenario: GP clinic in the heart of town.
Patient was a lady in her mid-40's complaining of a vague vaginal discomfort of 2 weeks duration. No significant medical history of note; menstrual history was also normal, with LMP 2 weeks prior to consultation.
After taking her history, I proceeded with an abdominal examination and then a PV during which I was surprised to feel a firm irregular mass in the posterior fornix of the vaginal vault. Thoughts of "tumor", fungating mass" etc ran through my mind, but I didn't want to say anything until I could visualise it. I proceeded with a speculum exam & saw a brownish colored FOUL SMELLING mass with a tail - it was a retained tampon (her LMP was 2 weeks prior, which allowed for Lord knows what kind of micro-organisms to proliferate in that very fertile medium...).
The patient was shocked when I told her what it was, & I could tell that until I actually showed her the offending object, she could not believe that she had forgotten to remove it.
My consultation room smelt like something had died and was decomposing, even after the patient had left; and we had to allow it to air out for several minutes, spray plenty of air freshener before it was fit for occupation again. The last time I had experienced something so malodourous was as a medical student doing the forensic path posting and had to undergo the "traditional" exposure to a decomposing body - that smell just sticks to your clothes for the rest of the day...