Outcomes after diagnosis of vaginal intraepithelial neoplasia

Abstract

Objective: To describe presenting characteristics and outcomes after a diagnosis of vaginal intraepithelial neoplasia (VAIN).

Materials and methods: Histologically confirmed cases of VAIN identified colposcopically after abnormal cytology were reviewed retrospectively. VAIN 1 was managed with observation, office loop excision, or laser ablation; unifocal or clustered VAIN 2,3 was managed with loop excision; and multifocal VAIN 2,3 was managed with laser ablation. Women were followed up cytologically at 6-month intervals. Clearance was defined as 2 consecutive negative cytology results.

Results: Thirty-six cases were identified with adequate follow-up (median = 20 months). VAIN 1 was found in 17 women, VAIN 2 in 8, and VAIN 3 in 11. All VAIN 1 lesions treated with loop excision were cleared, as were 8 of 12 VAIN 1 cases observed without therapy, 5 of 8 cases of VAIN 2, and 7 of 11 cases of VAIN 3. One woman had persistent VAIN 2; all other cases of persistence were low grade. No cases of progression and no treatment complications were identified.

Conclusions: This management strategy seemed to be safe and effective for the control of VAIN.