Management of Vaginal Precancerous Lesions

If the vaginal dysplasia is low grade, meaning the cells more closely resemble healthy cells than abnormal cells, doctors may recommend observation. Some types of human papillomavirus, or HPV, can cause dysplasia in the cells that line the vagina. However, these changes may go away on their own if the body can fight the infection.

You may need to see your doctor every six months. He or she uses colposcopy, with or without a biopsy, to examine the vagina. This enables the doctor to determine if dysplasia is still present.

If you smoke, your doctor will urge you to quit. Perlmutter Cancer Center’s Tobacco Cessation Programs can provide assistance. Smoking can increase the chances of vaginal dysplasia progressing to cancer.

For lesions that occur in more than one area of the vagina and that are higher grade, meaning the cells more closely resemble abnormal than healthy cells, doctors may prescribe topical chemotherapy. This is a cream containing fluorouracil (5-FU) that you apply directly to the lining of the vagina every other day for about 10 weeks.

Fluorouracil may cause some irritation in the vagina. Doctors manage this by adjusting the dose.

Your doctor may perform a wide excision to remove a precancerous lesion in the vagina. For this procedure, he or she removes the growth, along with a border of healthy tissue, to ensure all precancerous cells have been removed.

Surgery requires general anesthesia and is performed in a hospital. You can usually go home the same day.

You may experience some minor bleeding and discomfort afterward. Doctors can prescribe medication for any pain you may experience.

Your doctor may use laser surgery to destroy abnormal cells in the vagina if they occur in more than one area and he or she does not suspect the cells are cancerous. For this procedure, a colposcope is used to magnify and light the vagina while laser light is delivered to precancerous lesions.

The procedure usually requires general anesthesia and is performed in a hospital. You can typically go home the same day.

After laser surgery, you may have some minor bleeding or vaginal discharge for several days.