Upper vaginectomy for the treatment of vaginal intraepithelial neoplasia

Am J Obstet Gynecol. 2005 Aug;193(2):577-80; discussion 580-1. doi: 10.1016/j.ajog.2005.03.055.

Abstract

Objective: The purpose of this study was to evaluate the use of upper vaginectomy for the treatment of vaginal intraepithelial neoplasia (VAIN).

Study design: We conducted a retrospective review. Between August 1, 1985 and April 30, 2004, 105 patients were identified who had undergone upper vaginectomy for VAIN.

Results: Thirty-six patients had previously been treated for VAIN. Mean operative time and estimated blood loss were 55 minutes and 113 mL, respectively. Ten percent had intraoperative complications. Twenty-three (22%) patients had negative findings on final pathologic examination, and invasive cancer was found in 13 (12%) patients. Four patients had postoperative complications. Follow-up was available in 52 patients; 46 (88%) remain without recurrence at a mean follow-up of 25 months.

Conclusion: In our patients, upper vaginectomy was efficacious for the treatment of VAIN. The procedure led to the diagnosis of occult invasive cancer in 12% of these women.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma in Situ / surgery*
  • Carcinoma, Squamous Cell / surgery
  • Colposcopy
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Neoplasms, Multiple Primary / surgery
  • Retrospective Studies
  • Uterine Cervical Neoplasms / surgery
  • Vagina / surgery*
  • Vaginal Neoplasms / surgery*