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AIN examination : an examination of the mucous membrane at the anus

The mucous membrane contains cells and is a protective layer in and around the anus. Sometimes, a virus can cause cells to change and become abnormal. These cells are called AIN: anal intraepithelial neoplasia. The abnormal cells can turn into anal cancer. The earlier AIN is detected by AIN examination, the sooner you can get treatment.

: table-of-contents-title

About AIN The AIN examination How to prepare
How the examination works Advice for at home When to contact us?
The results Treatments Contact
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About AIN

AIN is short for anal intraepithelial neoplasia: a virus in your body that changes the mucous membrane in and around the anus. This virus is called human papillomavirus (HPV).
AIN doesn’t usually cause symptoms.
AIN can come back; if you have had AIN before, you can get AIN again. It is, therefore, a good idea to get yourself examined regularly.
Most people who have sex have had HPV. Usually, the body clears HPV on its own. HPV can change into cervical cancer in women. HPV can also change into anal cancer, in both men and women.

The AIN examination

In an AIN examination, the doctor will examine your anus on the inside and outside. The doctor will probably remove a piece of the mucous membrane for testing.
An AIN examination lets you know if you have abnormal cells. Treating abnormal cells quickly reduces the chances of the cells turning into anal cancer. An AIN examination cannot stop you from getting anal cancer.

How to prepare

For a reliable result, there are a few rules to follow from 24 hours before the examination:

  • If you take blood thinners, you can continue to do so.
  • Do not eat spicy food.
  • No anal sex.
  • Do not insert objects into the anus.
  • Do not flush anally.

How the examination works

The examination takes 30 to 45 minutes.

Before the examination

The examination is done by 2 healthcare professionals: 1 doctor and 1 assistant.

  • The doctor will ask you some questions about your sex life in the last 6 months. If you have any symptoms, the doctor will also discuss these with you.
  • You can take off your trousers, underwear and shoes in the changing room. Men will be given a towel to hold up and cover the scrotum and penis during the examination.

Before the examination

The examination is done by 2 healthcare professionals: 1 doctor and 1 assistant.

  • The doctor will ask you some questions about your sex life in the last 6 months. If you have any symptoms, the doctor will also discuss these with you.
  • You can take off your trousers, underwear and shoes in the changing room. Men will be given a towel to hold up and cover the scrotum and penis during the examination.

The examination

  • You sit in a special chair.
  • You put your legs in the leg rests.
  • The chair raises and tilts back so that the doctor can examine the anus properly.
  • The doctor first examines the outside of the anus with a special, magnifying camera and acetic acid.
    The skin around the anus has many folds. The folds make it difficult to see any abnormalities. The camera magnifies the images and makes it easier for the doctor to see if there is an abnormality.
    The acetic acid allows the doctor to see an abnormality better. The acetic acid may feel cold or wet. It may also burn a little.
  • If the doctor sees an abnormality, they take a photograph.
  • After examining the outside of the anus, the doctor examines the inside of the anus.
  • Using lubricant, the doctor inserts a proctoscope (a thin, hollow tube with a light and camera) into the anus. This allows the doctor to take a closer look at the mucous membrane in the anus.
  • The doctor inserts a cotton swab with a gauze containing acetic acid through the proctoscope. The acetic acid may feel cold or wet. It may also burn a little.
  • The doctor removes the proctoscope and lets the cotton swab sit for 1 minute.
  • After 1 minute, the doctor removes the swab.
  • The doctor then inserts the proctoscope again and closely examines the folds of the anus. The acetic acid allows the doctor to see an abnormality better.
  • If the doctor sees an abnormality, they will take a photo for your medical records. After your treatment, the doctor will take another photo. The difference is then easy to see.
  • If the doctor sees an abnormality in or outside the anus, the doctor will take a biopsy. A biopsy means that the doctor removes a piece of mucous membrane for testing.
    For the biopsy of the inside of the anus, you usually do not get an anaesthetic because there are few nerves in the mucous membrane of the anus. If you are given an anaesthetic, it is with an injection, cream or liquid.
    For the biopsy on the outside of the anus, the doctor will first numb the skin. You will not feel any pain but you may feel some pressure.

After the examination

  • The skin or mucous membrane around the anus may bleed for a few days. You will be given pads to make sure no blood gets on your clothes.
  • The doctor will send the biopsy to the laboratory for testing.
  • If you feel well, you may go home immediately after your treatment or examination. You may drive, cycle or travel by public transport on your own.

Advice for at home

  • No anal sex for 1 week.
  • The wounds can make it easier for you to get an STI or infection. Use a condom until the wounds have healed.

When to contact us?

A few days of blood in your stools or on the toilet paper is normal. If you lose a lot of blood, contact your doctor.

The results

The doctor will call you after 2 weeks and discuss the results with you.
There are 4 possible results:

  • You have no abnormal cells.
  • AIN 1 or low-grade AIN.
    This means there are only abnormal cells in the upper layer of the mucous membrane near the anus.
    No treatment is needed for AIN 1. The body can clear the cells on its own. You will get an appointment for another examination after 1 year.
  • AIN 2 or high-grade AIN.
    This means there are abnormal cells in a deeper layer of the mucous membrane near the anus.
    Treatment is available for AIN 2.
  • AIN 3 or high-grade AIN.
    This means there are abnormal cells throughout the mucous membrane near the anus.
    Treatment is available for AIN 3.

The doctor will discuss the next steps with you.

Treatments

AIN treatment

Contact

If you have any questions after reading this, ask the outpatient clinic via MijnOLVG. On workdays, you can also call.

Polikliniek Dermatologie, locatie Oost, P1
= Dermatology Outpatient Clinic, location East, P1
+31 (0)20 510 86 84 (on workdays from 08:15 to 16:15)

Polikliniek Dermatologie, locatie West, route 16
= Dermatology Outpatient Clinic, location West, route 16
+31 (0)20 510 86 84 (on workdays from 08:15 to 16:15)

Polikliniek Interne Geneeskunde, locatie Oost, P2
= Internal Medicine Outpatient Clinic, location East, P2
+31 (0)20 599 30 37 (on workdays from 08:15 to 16:15)

Polikliniek Interne Geneeskunde, locatie West, route 14
= Internal Medicine Outpatient Clinic, location West, route 14
+31 (0)20 510 88 82 (on workdays from 08:15 to 16:15)

The information on this page comes from the department of OLVG. Last modified: