Surgical treatments for vulvar and vaginal dysplasia - A randomized controlled trial

Title

Surgical treatments for vulvar and vaginal dysplasia - A randomized controlled trial

Creator

Von Gruenigen V E; Gibbons H E; Gibbins K; Jenison E L; Hopkins M P

Publisher

Obstetrics and Gynecology

Date

2007
2007-04

Description

OBJECTIVE: To compare pain, adverse effects and recurrence of dysplasia in patients with vaginal intraepithelial neoplasia or vulvar intraepithelial neoplasia prospectively treated by carbon dioxide laser or ultrasonic surgical aspiration. METHODS: Patients were randomly assigned to receive treatment by laser or ultrasonic surgical aspiration from 2000-2005. Preoperative biopsy was done to confirm presence of dysplasia. Patients completed a visual analog scale regarding pain and were evaluated at 2-4 weeks to assess scarring, wound healing, and adverse effects. Patients returned every 3 months for 1 year for pelvic examination and cytology to assess recurrence. Follow-up colposcopy and biopsy were used at the discretion of the treating physician. Student t test, X-2, analysis of variance and multiple logistic regression were used for analysis. RESULTS: One hundred ten patients were randomly assigned. Ninety-six (87.3%) patients completed 1 year follow-up. Mean age of patients was 48.5 years. Mean visual analog scale score was significantly lower in patients treated by ultrasonic surgical aspiration (20.7 compared with 35.1; P=.032). For patients with vulvar lesions, there was less scarring with ultrasonic surgical aspiration (P<.01). Recurrence overall was 25% and was similar for ultrasonic surgical aspiration compared with laser (relative risk 0.96, 95% confidence interval 0.64-1.50, number needed to treat 95.6). Recurrence was associated with younger age (P<.01). CONCLUSION: Patients treated with ultrasonic surgical aspiration for vulvar and vaginal dysplasia reported less postoperative pain. Vulvar scarring was more common in patients treated by the laser. There was no difference in recurrence of dysplasia during a 1-year follow-up period between the two surgical modalities. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www. clinicaltrials.gov, NCT00394758.

Subject

aspiration; carbon-dioxide laser; carcinoma; excision; imiquimod cream; intraepithelial neoplasia-iii; management; Obstetrics & Gynecology; therapy; vaginectomy; vaporization

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

942-947

Issue

4

Volume

109

Citation

Von Gruenigen V E; Gibbons H E; Gibbins K; Jenison E L; Hopkins M P, “Surgical treatments for vulvar and vaginal dysplasia - A randomized controlled trial,” NEOMED Bibliography Database, accessed October 28, 2021, https://neomed.omeka.net/items/show/7424.

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