Treatment of Vulvar Intraepithelial Neoplasia
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Vulvar intraepithelial neoplasia, also known as VIN, is a skin disease of the vulva. The vulva is the external part of female genitalia. Vulvar intraepithelial neoplasia causes skin cells in this region to become abnormal and their appearance starts to change. This condition is considered to be precancerous, as there is a danger that it could later turn into vulvar cancer. That's why it's so important to treat it. 15% of VIN develops into vulvar squamous cell cancer. Vulvar cancer is very rare, accounting for less than 1% of all cancer cases.
Neoplasia is used to describe the abnormal proliferation of cells and intraepithelial means that this process occurs strictly in epithelial tissue. Although the cause of this disease is known, it is believed that in most cases VIN is caused by HPV (human papillomavirus) infection. It can also be caused by vulvar lichen sclerosus, which is another disease of the vulva.
- Itching in the vulva
- Soreness
- Burning
- Painful sensations during sexual intercourse
- Redness
- White spots in the vulva
Vulvar intraepithelial neoplasia can also result in genital warts, which are more difficult to treat. A woman can experience mild to intense vulvar itching. Skin lesions in progressed stages can turn colors from pink to white to brown.
Vulvar intraepithelial neoplasia is usually diagnosed during a regular check-up at a gynecologist, when the doctor notices changes in the vulval structure. If there is a suspicion of vulvar cancer, a patient needs to undergo a biopsy.
A biopsy is an excision of a small part of tissue for the purpose of examination, to determine if the cells are neoplastic or malignant. Vulvar tissue in this case will be examined under the microscope. A biopsy is usually performed under local anesthetic to numb the vulvar region.
- A partial vulvectomy is performed in less severe cases of vulvar intraepithelial neoplasia. Only the affected part of the vulva is removed. In some cases, only the top layer of the vulvar skin is removed.
- An extended vulvectomy is performed in severe cases and more than 80% of vulvar tissue is removed. Sexual function is preserved. After this procedure, the patient will need time to recover.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
