Medical therapy is usually successful in treating a patient with hyperprolactinemia due to a pituitary adenoma. Sometimes surgery is necessary.

Indications for pituitary surgery:

(1) failure of optimal medical therapy (resistance, intolerance)

(2) long-term drug treatment not acceptable

(3) tumor pressing on the optic chiasm

(4) nonfunctional adenoma large enough to cause a stalk effect (interruption of dopamine delivery from the hypothalamus)


Long-term follow-up after surgery indicate a significant risk of recurrence, especially for macroprolactinomas.

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