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Vaginal Intraepithelial Neoplasia (VaIN): Diagnosis and Management

  • Xingnan Zhou
  • Tien Anh Nguyen Tran
  • Robert W. Holloway
Chapter

Abstract

Vaginal intraepithelial neoplasia (VaIN) is a relatively uncommon and asymptomatic preneoplastic lesion associated with human papillomavirus (HPV) of the lower genital tract. The diagnosis is usually suspected with abnormal cervical-vaginal cytology and confirmed by punch biopsy. The treatment of VaIN varies depending on several factors including grade of the dysplasia, location, and extent of lesions, patients’ characteristics including age and onset of HPV infection, and previous therapeutic procedures. The four main treatment methods include surgery, ablation, topical therapies, and radiation (brachytherapy). All treatments have reasonably good success but are limited by their unique side effects, and all are associated with some risk for recurrence. Patients require long-term monitoring to survey for recurrence or progression to vaginal cancer. HPV vaccination is a promising strategy to reduce the incidence of VaIN and vaginal cancer.

Keywords

Vaginal intraepithelial neoplasia (VaIN) Cytology Biopsy Vaginectomy CO2 laser Loop electrosurgical excision procedure (LEEP) Cavitational ultrasonic surgical aspiration (CUSA) Photodynamic therapy (PDT) Imiquimod 5-Fluorouracil (5-FU) Trichloroacetic acid (TCA) Estrogen Brachytherapy HPV vaccine 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Xingnan Zhou
    • 1
  • Tien Anh Nguyen Tran
    • 2
  • Robert W. Holloway
    • 3
  1. 1.Department of Obstetrics and GynecologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
  2. 2.Department of PathologyFlorida Hospital OrlandoOrlandoUSA
  3. 3.Florida Hospital Gynecologic OncologyOrlandoUSA

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