Outcomes after diagnosis of vaginal intraepithelial neoplasia

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

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.

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.

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