Mild vaginal dysplasia — low-grade vaginal intraepithelial neoplasia (VaIN 1) — requires a careful management decision. The clinical approach depends on lesion characteristics and symptom burden, with pathways ranging from watchful observation to active topical intervention.
Low-grade VaIN lesions are generally managed conservatively under observation. Active treatment becomes relevant when disease presents as bulky warty lesions, with the decision guided by the extent of involvement and associated symptoms.
For low-grade lesions without significant symptoms, observation is the primary strategy. Where bulky warty disease is present, a topical treatment course may be considered — though the specific agent, selection criteria, and full regimen are outlined in the complete protocol.
The primary clinical target is clearance of VaIN lesions on completion of the initial management course, with the patient remaining free of VaIN at 6 months of follow-up.
DOI: 10.1136/ijgc-2022-004213