Rovinskaya O.V., Zarochentseva N.V., Krasnopolsky V.I. and other HPV-associated lesions of the dome
vagina in women after hysterectomy. Questions of practical colposcopy. Genital infections.
2022; (1): 52–58.
DOI 10.46393/27826392_2022_1_52
Annotation:
Vaginal intraepithelial neoplasia (VaIN) is a rare dysplastic lesion of the vaginal mucosa associated with human papillomavirus (HPV), with an estimated incidence of 0.2 to 2 per 100,000 women per year. The main reason for the development of VaIN is the persistence of HPV even in patients after hysterectomy.
Purpose of the study: to assess the condition of the vaginal dome and determine HPV infection in women after hysterectomy.
Material and methods. 133 patients after total hysterectomy were examined. The average age of the patients was 46.9 years. The following methods were used during the examination: cytological, HPV testing, instrumental (extended vaginoscopy), histological.
Results. The frequency of HPV infection among all examined patients who underwent hysterectomy was 27.8%. After hysterectomy, the following genotypes were more often detected: HPV type 16 - in 15.8%, type 68 - in 4.5% of women. A simultaneous combination of two or more types of HPV was detected in 8.3% of patients. HSIL was histologically confirmed in 15 (11.28%) women, LSIL – in 10 (7.52%) and vaginal Cr – in 1 (0.75%) patient.
Conclusion. The results obtained indicate a high incidence of HPV infection among women after panhysterectomy, especially with a history of CIN. Persistence of HPV in these patients is the cause of the development of vaginal intraepithelial lesions. For early detection of vault and vaginal wall lesions, hysterectomy patients require more intensive follow-up with vaginal vault cytology, HPV testing, and extended vaginoscopy during the first years after hysterectomy, even with negative excision margins.
Journal “Issues of practical colposcopy. Genital infections" No. 1_2022