Best practice in management of paediatric and adolescent hydrosalpinges: a systematic review

Background: Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can present mimicking an acute abdomen or can be asymptomatic. Management of paediatric hydrosalpinx varies, but often involves surgical removal of the affected tube. Methods: In June 2015, a literature search using relevant keywords was completed on MEDLINE and EMBASE databases to determine best management of paediatric hydrosalpinx. Results: We found 66 cases from 38 articles. Surgical intervention took place in 74% of cases (n = 49). The most common surgical intervention was salpingectomy. In 3% of cases (n = 2), nonsurgical medical management with hormonal therapy was utilized, with post-operative improvement in symptomology. In 23% of cases (n = 15), conservative management was utilized: 2 of these cases torted, 4 cases persisted and 9 cases resolved. Conclusion: Overall, the results of this review demonstrate that there are comparable outcomes between surgical, medical and conservative management. However, medical and conservative management was not often offered, and more research is needed on the subject. (C) 2015 Elsevier Ireland Ltd. All rights reserved.