Introduction:
Vaginal intraepithelial neoplasia (VAIN)s an uncommon condition that affects women in Singapore. However it can cause considerable anxiety amongst women who are afflicted. Though its not cancerous, it can progress into vaginal cancer. So,what are its causes, and risks and how can it be treated? Please read on to find out.
VAINa us a condition where abnormal cells grow in the vaginal lining (epithelial). It can be classified into 3 main groups showing the extent to which it has affected the lining of the vagina. The grading includes;
- VAIN 1 (Low Grade); the abnormal cells affect the liwer third of the vaginal lining.
- VAIN 2 (Moderate Grade); The VAIN is seen in nearly 66% of the thickness of the vaginal lining.
- VAIN 3 (High Grade); The abnormal cells are present in the full thickness of the vaginal lining.
VAIN2 and VAIN3 are considered High Grade squamous epithelial lesions (HSIL) with a higher potential to turn malignant if untreated. The overall risk is about 12% according to studies.
Causes of Vaginal Intraepithelial Neoplasia
The following are the causes and risk factors of Vaginal Intraepithelial Neoplasia (VAIN);
- Human papillomavirus (HPV); is the most common cause. The virus is found in about 85 % patients with VAIN. Immunisation with the HPV vaccine will help to reduce the risk of getting this condition.
- Suppressed immunity from various conditons such as HIV, medications or even smoking increases the risk of VAIN
- Cancer or Precancerous Conditions; If you already have cancer in your cervix or vulva, the risk of VAIN increases
Symptoms and Diagnosis
Many women with VAIN do not have symptoms but some do experience vaginal bleeding or vaginal discharge. A colposcopy and biopsy of the vagina is usually performed to clinch the diagnosis as well as to access the extent of the disease.
Treatment of Vaginal Intraepithelial Neoplasia
VAIN 1 is considered a low grade lesion with a low risk or progression to cancer, hence, your doctor may not suggest any particular treatment. This is because, in this group, the condition is mild and may not call for active management. On the contrary, he can conduct a follow-up colposcopy for a regular checkup to monitor any changes.
However, when you are experiencing high-grade VAIN and are at a higher risk of developing cancer your doctor may recommend the following treatment options;
- Surgery
Laser Treatment; This involves using a strong beam of light to burn away the abnormal cells lining of the affected vagina
Vaginectomy this involves cutting away the affected part of the vagina
- Use of Medications; Your doctor may suggest you apply certain immunomodulating creams such as imiquinod or chemotherapy cream such as 5FU to the affected area
- Radiotherapy; This is a very uncommon treatment method used for VAIN and may be offered if all else fails
Remember, the treatment your doctor administers to you may differ from another patient’s. This is because vaginal intraepithelial neoplasia varies depending on the size, how severe the condition is, and its location. This, however, does not disqualify factors such as age, sexual activity, and other vaginal conditions among others.
Conclusion
Vaginal Intraepithelial neoplasia (VAIN) is an uncommon condition and is mostly caused by HPV. High grade VAIN would require treatment to prevent progrrssion to cancer and different methods can be used for the treatment.
