hyperprolactinemia
HYPERPROLACTINEMIA
Hyperprolactinemia is the presence of elevated prolactin levels that occurs in about one-thirds of patients w/ chronic kidney disease & resolves after successful transplantation.
It may cause visual field defects or headache in both men and women.
In women, signs and symptoms include menstrual irregularity, galactorrhea, infertility, vaginal dryness, dyspareunia, loss of libido and reduction in vertebral bone density (in sustained, pronounced hyperprolactinemia).
While in men, signs and symptoms include diminished libido, hypogonadism, gonadotrophin suppression, osteopenia, decreased muscle mass, and decreased facial hair that may occur in prolonged hyperprolactinemia.

Surgical Intervention

Transsphenoidal Surgery

  • Preferred method
    • Craniotomy is rarely performed

Indications:

  • Patients who are resistant to or exhibit non-tolerance to optimal medical therapy
  • Patients w/ intrasellar tumor & long-term medical treatment is not acceptable
  • Patients w/ tumors pressing on the optic chiasm
  • Effects:
    • Microprolactinomas: Initially 70% achieve prolactin (PRL) normalization
    • Macroprolactinomas: Only 30% are successfully resected
    • Recurrence of microprolactinomas & macroprolactinomas occurs in 20% of patients w/in 1 year of surgery
    • Recurrence rates reach 50% in long-term follow-up of macroprolactinomas
  • Potential complications: Usually infrequent when performed by experienced surgeons
    • Mortality rate: 0.3%
    • Morbidity rate: 0.4%
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