title: Conservative management of vaginal intraepithelial neoplasia (VAIN) by laser CO2.
abstract: Carbon Dioxide Laser ablation therapy was originally offered to 25 women with Vaginal Intraepithelial Neoplasia (VAIN). The disease was primary in 12 and secondary after a previous hysterectomy in 13 cases. Treatment was accomplished under local anesthesia in 22 cases and was well-tolerated by all patients. The age of the patients ranged from 19 to 68 with a mean age of 44 years. All women were followed-up by cytology and colposcopy within a time period of 35 to 82 months (mean 49 months). Eight patients relapsed resulting in a failure rate of 32%. A second Laser CO2 treatment was offered to these patients with a final cure rate of 84% (21/25). The four cases in which the disease reappeared, after the 2nd treatment, were managed by upper colpectomy (3 cases) and follow-up (1 case). Laser CO2 ablation is an acceptable treatment modality for VAIN considering the promising cure rates and the preservation of the anatomic integrity of the vagina. Close colposcopic follow-up of these patients is necessary for early detection of disease relapses.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Athens University, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Diakomanolis
authors.forename: A
authors.initials: A
authors.lastname: Rodolakis
authors.forename: G
authors.initials: G
authors.lastname: Sakellaropoulos
authors.forename: K
authors.initials: K
authors.lastname: Kalpaktsoglou
authors.forename: D
authors.initials: D
authors.lastname: Aravantinos
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D002245:Carbon Dioxide / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000601:surgery*
chemical_list: D002245:Carbon Dioxide