Questions abound: How did the woman not realize that her body contained a foreign object after she and her partner had finished their sexual activity? How did she not realize this the next day, or any day thereafter for the next 3,650 days — until she faced near-death? The woman wasn't suffering from depression or psychosis, she had a normal IQ, and she had not been abused, the Journal of Sexual Medicine article noted — ruling out obvious factors that might have explained the woman's obliviousness regarding the toy in her vagina. Yet, somehow, it went unnoticed until she developed a vesicovaginal fistula (an abnormal passageway through which urine flows into the vagina) and obstructive uropathy (in which urine flows not from the kidneys to the bladder but rather back into the kidneys, due to bladder blockage).