DES-related vaginal lesions

The teratogenic effects of DES predispose the exposed female to an increased frequency of vaginal adenocarcinoma and possibly to an increase in vaginal squamous intraepithelial neoplasia. Medical efforts are directed toward detection of these neoplasma by physical examination and by cytologic and biopsy techniques. Treatment is indicated in the patient with adenosis alone only when it becomes symptomatic, with excessive vaginal discharge. Intraepithelial lesions require therapy by local tissue destruction. The laser offers the most promise as a therapeutic modality for the treatment of either symptomatic adenosis of intraepithelial lesions as it causes only minimal scarring.