IMR Press / EJGO / Volume 40 / Issue 4 / DOI: 10.12892/ejgo5085.2019
Open Access Original Research
LaserCo2 role in the treatment of vaginal intrepithelial neoplasia (VAIN) retrospective study involving 587 patients
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1 Department of Gynecology and Obstetrics, Spedali Civili of Brescia, University of Brescia, Brescia, Italy
2 Obstetrics and Gynecology Unit, “Dell’Angelo” General Hospital, Mestre, Venice, Italy
Eur. J. Gynaecol. Oncol. 2019 , 40(4), 538–542; https://doi.org/10.12892/ejgo5085.2019
Revised: 17 December 2018 | Published: 10 August 2019
Abstract

Aim of the Study: To evaluate the presentation features of intraepithelial vaginal neoplasia, the clinical outcome in LaserCO2 vaporization treated patients, the therapeutic results, the procedure-associated complications, and the risk factors for recurrence. Materials and Methods: This was a retrospective study of 587 consecutive patients diagnosed with vaginal intraepithelial neoplasia (VAIN) and treated by laserCO2 vaporization at Spedali Civili of Brescia between January 1990 and June 2018. All the patients underwent cytological and colposcopic follow-up. Recurrences were evaluated in terms of clinical features and association with risk factors. Chi-Square was used to establish the correlation between the two groups. Results: Mean age was 40.9 years. Most lesions were localized at the vaginal superior third (94.4%), 55.3% were multifocal, and 49.5% were associated with synchronous intraepithelial cervical neoplasia (CIN). In 8% of cases, VAIN affected the vaginal vault in hysterectomized patients. In 84,4% among the 282 evaluable cases, a vaginal swab was positive for HPV. HR-HPV was more frequent in high-grade lesions. No intraoperative complications were registered and the treatment was well tolerated. Follow-up was available for 428 patients with a mean duration of 56 months. Complete regression of VAIN after treatment was 85.3% with a recurrence rate of 14.7%. HR-HPV has been identified as a significant risk factor for recurrence. Conclusions: LaserCO2 vaporization is a safe, low impact, and effective technique for VAIN therapy with a high success rate. HR-HPV must be considered an independent risk factor for recurrence.

Keywords
Vaginal intraepithelial neoplasia
Laser vaporization
Human papillomavirus
Colposcopy
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