The Effect Of Transsphenoidal Surgery To Adult Prolactinoma Patients Pituitary Function

Aim:To investigate the effects of transsphenoidal surgery to prolactinoma patients pituitary function.Methods:Between Oct 2005 and Nov 2007,200 cases of adult patients(age between 18-45) were treated in Huashan Hospital.We retrospectively analyzed their clinical data.Following-up were their endocrinological levels and MRI.Diagnosis was ensured by serum PRL,MRI and pathological examination.Results:The ratio of male to female was 70:130.The ratio of microadenoma:macroadenoma in female is 96:34;The ratio of microadenoma: macro in male is 14:56.The incidence of TSH-deficiency and ACTH-deficiency pre-operation in male is 8.6%and 10%,while in female it is 1.5%and 3.1%.The incidence of new anterior pituitary dysfunction post transsphenoidal surgery is 1%. The incidence of transient diabetes insipidus post transsphenoidal surgery is 39.5%.Finally,we judged the patients as:cured in 72.5%(145/200),not cured in 27.5%(55/200);The cured rate in female is 81.5%(106/130),while in male it is 55.7%(39/70).The rate of menstrual restoring in female is 69.2%(90/130),partly improved in 18.5%(24/130),no improved inl2.3%(16/130).Restore of sexual dysfunction in male is 22.8%(16/70),partly Improved in 32.9%(23/70),no improved in 44.4%(31/70).Conclusion:Transsphenoidal surgery has little effect on patients' anterior pituitary function.The incidence of new anterior pituitary dysfunction post transsphenoidal surgery is very low.The incidence of transient diabetes insipidus post transsphenoidal surgery is high.The cure rate in female is higher than that in the male,as so as the improvement of reproductive function.