title: Therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia following hysterectomy due to premalignant and malignant lesions.
abstract: OBJECTIVE
  The aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia (VAIN) after hysterectomy in Chinese women and to identify factors affecting persistence/recurrence.
  
  
  METHODS
  Twenty-eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Cox regression analysis was used to identify independent factors predicting persistence/recurrence.
  
  
  RESULTS
  All VAIN patients achieved remission after two episodes of laser treatment, with 85.7% complete regression in group 1 and 54.5% in group 2. The first episode of the treatment had a significantly higher success rate in group 1 than in group 2 (46.2% vs 0.0%). All patients had no recurrence during a mean follow-up time of 22.8-27.8 months (range 12-39 months). However, infection persisted in 21 (61.8%) of 34 human-papillomavirus-positive patients after laser vaporization. Severity of VAIN was the only significant independent predictor of persistence/recurrence after one episode of the treatment (adjusted odds ratio, 4.08; 95% confidence interval, 1.28-12.96; P = 0.017). Laser treatments were well tolerated with no major side-effects.
  
  
  CONCLUSIONS
  Laser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow-up is required to assess the long-term efficacy of laser treatment.
authors.affiliation: Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital of Capital Medical University, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Kong
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Wu
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Wang
authors.forename: Wei-Yuan
authors.initials: WY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D011230:Precancerous Conditions / Q000601:surgery*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014625:Vaginal Neoplasms / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000601:surgery
keywords: hysterectomy; laser vaporization; vaginal intraepithelial neoplasia