Vaginal intraepithelial neoplasia (VAIN) is a condition that frequently poses therapeutic dilemmas for gynecologists. VAIN represents dysplastic changes to the epithelium of the vaginal mucosa, and like cervical neoplasia, the extent of disease is characterized as levels I, II, or III dependent upon the depth of involvement in the epithelial layer by dysplastic cells. While VAIN itself typically is asymptomatic and not a harmful condition, it carries a 12% risk of progression to invasive vaginal carcinoma, so accurate identification, thorough treatment, and ongoing surveillance are essential. vaginal intraepithelial neoplasia (VaIN) has increased steadily over the past several decades as a result of heightened awareness, expanded cytologic screening, and the liberal use of colposcopy. The relative rarity of VaIN, which is far less common than cervical intraepithelial neoplasia (CIN) or vulvar intraepithelial neoplasia (VIN), is an impediment to a thorough understanding of the disease process and its natural course. As a result, much of this information is an extrapolation of our knowledge of the pathophysiology of cervical and vulvar intraepithelial neoplasia.
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