Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation
Accepted: 18 January 2021
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Hydrosalpinx in pre-pubertal children and non-sexually active adolescents is a rare finding with several etiology and negative impact on future female fertility. The therapeutic approach in these specific populations is debated and it must consider its etiology and adult guidelines focused on fertility issues, which suggest laparoscopic salpingectomy. We described two adolescent cases (15 years asymptomatic and 13 years with abdominal pain) presenting a monolateral hydrosalpinx secondary to surgery for Hirschsprungâ€™s disease and complicated appendicitis, respectively. Both patients underwent to uncomplicated robotic-assisted salpingectomy, with uneventful follow-up and preserved ovarian function. Robotic-assisted salpingectomy for hydrosalpinx secondary to previous surgical conditions is a safe and careful approach for adolescents in order to preserve ovarian vascularization, function and future fertility.
Bertozzi M, Noviello C, Molinaro F, et al. Isolated fallopian tube torsion in pediatric age: An Italian multicenter retrospective study. J Pediatr Surg (2019) doi: 10.1016/j.jpedsurg.2019.04.032. [Epub ahead of print] DOI: https://doi.org/10.1016/j.jpedsurg.2019.04.032
Boukaidi SA, Delotte J, Steyaert H, et al. Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey. J Pediatr Surg 2011; 46, 1425-1431 DOI: https://doi.org/10.1016/j.jpedsurg.2011.01.033
Harb HM, Al-Rshoud JF, Karunakaran B, et al. Hydrosalpinx and pregnancy loss: a systematic review and meta-analysis. Reprod Biomed Online. 2019; 38(3): 427-441 DOI: https://doi.org/10.1016/j.rbmo.2018.12.020
Volodarsky-Perel A, Buckett W, Tulandi T. Treatment of hydrosalpinx in relation to IVF outcomes: a systematic review and meta-analysis. Reprod Biomed Online. 2019; 39(3): 413-432 DOI: https://doi.org/10.1016/j.rbmo.2019.04.012
Ng KYB, Cheong Y. Hydrosalpinx e Salpingostomy, salpingectomy or tubal occlusion. Best Pract Res Clin Obstet Gynaecol. 2019; 59: 41-47 DOI: https://doi.org/10.1016/j.bpobgyn.2019.01.011
Kazmi Z, Gupta S. Best practice in management of paediatric hydrosalpinges: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2019; 59: 41-47
Palazon P, Saura L, de Haro I, et al. Bilateral hydrosalpinx in patients with Hirschsprungâ€™s disease. J Pediatr Surg 2018; 53: 1945â€“1950 DOI: https://doi.org/10.1016/j.jpedsurg.2018.01.011
Cabral MD, Siqueira LM, Hydrosalpinx in postmenarchal nonsexually active girls: a review of 6 cases in a childrenâ€™s hospital. J Pediatr Adolesc Gynecol. 2015; 28(6): e203-7 DOI: https://doi.org/10.1016/j.jpag.2015.06.009
Merlini L, Anooshiravani M, Peiry B, et al. Bilateral hydrosalpinx in adolescent girls with Hirschsprungâ€™s disease: association of two rare conditions. AJR Am J Roentgenol 2008;190: W278-82 DOI: https://doi.org/10.2214/AJR.07.3183
Noventa M, Gizzo S, Saccardi C, et al. Salpingectomy before assisted reproductive technologies: a systematic literature review. J Ovarian Res. 2016 Nov 3; 9 (1): 74. DOI: https://doi.org/10.1186/s13048-016-0284-1
Van Voorhis BJ, Mejia RB, Schlaff WD, et al. Is Removal of Hydrosalpinges Prior to in Vitro Fertilization the Standard of Care? Fertil Steril. 2019 Apr; 111 (4): 652-656 DOI: https://doi.org/10.1016/j.fertnstert.2019.02.015
Chan CCW, Ng EHY, Li CF, et al. Impaired ovarian blood flow and reduced antral follicle count following laparoscopic salpingectomy for ectopic pregnancy. Hum Reprod 2003;18:2175â€“80 DOI: https://doi.org/10.1093/humrep/deg411
Gelbaya TA, Nardo LG, Fitzgerard CT, Horme G, et al. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinx. Fertil Steril 2006; 85: 1464-8 DOI: https://doi.org/10.1016/j.fertnstert.2005.10.036
Lass A, Ellenbogen A, Croucher C, et al. Effect of salpingectomy on ovarian response to superovulation in an in vitro fertilization-embryo transfer program. Fertil Steril 1998;70:1035â€“8 DOI: https://doi.org/10.1016/S0015-0282(98)00357-4
Luo J, Shi Y, Liu D, et al. The effect of salpingectomy on the ovarian reserve and ovarian response in ectopic pregnancy. A systematic review and meta-analysis. Medicine 2019; 98:47-53 DOI: https://doi.org/10.1097/MD.0000000000017901
Pelizzo G, Nakib G, Calcaterra V. Pediatric and adolescent gynecology: treatment perspectives in minimally invasive surgery. Pediatric Reports 2019; 11:8029 DOI: https://doi.org/10.4081/pr.2019.8029
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