Vaginal intraepithelial neoplasia (VAIN) accounts for 0.4% of the lower genital tract intraepithelial diseases. It:
- is usually asymptomatic
- mostly occurs in the upper vagina
- is associated with HPV
- may be detected following smear contamination
- has an acetowhite change on colposcopy.
Approximately 1–3% of women with cervical neoplasia have either coexisting VAIN or will develop it at a later date.
Treatment for VAIN includes:
- local excision
- chemotherapy (intravaginal 5-fluorouracil)
- physical destruction methods (e.g. laser, cryosyrgery, electrocautery or cavitational ultrasonic surgical aspiration)
- major surgical procedures (e.g. partial vaginectomy or total vaginctomy with graft)
- conservative surgical removal.
VAIN will represent a field change and, therefore, the vulva, cervix and perianal area must be examined to exclude VIN, CIN and anal intraepithelial neoplasia.