The prospective management of women with newly diagnosed vulval intraepithelial neoplasia: clinical outcome and quality of life.

Vulval intraepithelial neoplasia (VIN) is a premalignant skin condition with significant morbidities from standard surgical treatment. This two-year prospective study recruited women with newly diagnosed VIN for careful observation rather than primary surgical excision. Surgery was performed to exclude progression or for uncontrollable symptoms. Participants were seen six-monthly for clinical review and completion of questionnaires assessing depression and anxiety, quality of life, sexual functioning, and partner relationships. Eight women were recruited. Six women required immediate treatment and two women were observed carefully. By study completion, seven participants had undergone surgical treatment, often for symptom control. Women scored poorly on quality of life and sexual functioning scores; this did not appear to be due to depression or anxiety. In conclusion, careful observation does not appear a feasible option for most women with VIN since the majority require surgical treatment. VIN has an adverse impact on quality of life and sexual functioning.