1. Preferred pharmacological treatment. Women who have not had children combined with pituitary prolactin microadenoma can usually be treated with oral dopamine agonist DD oligocryptine, and it is reported in the literature that 70% of women can get pregnant after 2 months. With long-term treatment, the tumor size can be reduced and some patients can be cured. In young women who become pregnant after treatment with dopamine agonists, stroke or significant enlargement of the pituitary adenoma may occur during pregnancy, requiring emergency surgery if necessary. Long-term use of sniffing cryptine, some patients have difficulty in adhering to it due to heavy side effects, in this case surgery can also be an option. Xue-Ming Lu, Department of Neurosurgery, Jinan Military General Hospital
2. Transsphenoidal sinus surgery. Surgery is the most fundamental treatment for patients who are drug intolerant or dopamine agonist resistant. The success of surgery depends crucially on the experience of the operator, the size and aggressiveness of the tumor. 60% to 90% of patients achieve normal prolactin levels after surgery. Therefore, it is reasonable for patients to choose surgical treatment. The most important prerequisite, of course, is the low mortality rate of transsphenoidal surgery and the low chance that the surgery will affect normal pituitary function, the latter being very important for patients who want to have children. It is worth noting that long-term treatment with dopamine agonists may affect the efficacy of the procedure. The introduction of endoscopic techniques into transsphenoidal surgery results in less trauma, almost no damage to the nasal cavity, better intraoperative visualization, more complete tumor removal, better protection of the normal pituitary gland, faster patient recovery, more comfort during recovery, and better surgical outcomes.
3. Follow-up observation. Longitudinal studies have shown that only 7% of prolactin microadenomas can develop into larger tumor lesions. Therefore, for patients with prolactin microadenoma, if they have normal menstrual cycle and libido, and if they have mild overflow and are not planning to get pregnant, they can be followed up and observed without immediate treatment.
Consultation number 13188873256