New guidelines address treatment of pre-invasive lesions of the vulva

Four international medical societies have collaborated on consensus statements for physicians, published in the Journal of Lower Genital Tract Disease, about how to treat pre-invasive lesions of the vulva.

A pre-invasive vulvar lesion is an area of skin or mucosa that has not yet progressed to invasive malignancy (cancer) but has the potential to do so. “Pre-invasive vulvar lesions deserve specific attention, because beside the oncological risk, they affect not only functionality and body image but also psychosexual factors,” according to the lead author of the guidelines, Mario Preti, MD of the University of Torino, Italy, and his co-authors.

Lesions on a woman’s vulva can cause symptoms such as burning and itching that make intercourse painful, but they can be asymptomatic, the authors note, underscoring the need for correct vulvar examination.

The consensus statements were compiled after a systematic review of medical literature and were voted on by experts chosen by the four scientific societies. The document gives advice to physicians about the four main types of pre-invasive lesions that can develop on the vulva.

“Following treatment of pre-invasive vulvar lesions, women should be seen on a regular basis for careful clinical assessment, including biopsy of any suspicious area,” the authors of the consensus statements advise. The frequency of follow-up visits will depend on the type of lesion, patient age, and whether the patient has an infection, immunologic disease, or other lesions in the lower genital tract.

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