Prolactinomas: surgical therapy, indications and results.

This study indicates that transsphenoidal microsurgical removal of prolactinomas is highly effective for producing significant normalization of preoperative prolactin levels, resumption of menses, and the recovery of fertility in patients with microadenomas. Minimal morbidity and no mortality were encountered in this series. Surgical treatment in patients with microadenomas is comparable to bromocriptine therapy for achieving normalization of prolactin levels and fertility. In patients with macroadenomas, bromocriptine is more effective than surgery. This drug can also be used for achieving fertility when prolactin levels fail to normalize and resumption of menses does not occur following surgery. Radiation therapy should be reserved postoperatively for those patients who have macroadenomas with suprasellar or parasellar extension.