Diagnosis and management of vulvar and vaginal intraepithelial neoplasia

Vulvar and vaginal intraepithelial neoplasia are being encountered more fre quently in younger women. Histologic evaluation is mandatory for an accurat e diagnosis. Association with human papillomavirus infection and the multif ocal nature often make treatment difficult; recurrences are not uncommon. T he goal of therapy is to eliminate uncomfortable symptoms and malignant con version while preserving lower genital tract appearance and function. Treat ment must therefore be individualized for each patient to maintain vulvovag inal function and to avoid compromise to the clitoris, urethra, or anus whi le alleviating symptoms and preventing disease progression.