[Secondary osteoporosis UPDATE. Primary hyperparathyroidism]

It has been clarified that even mild primary hyperparathyroidism without typical symptoms ie, nephrolithiasis, bone disease, influences bone status and reduced bone density and increased fracture risk can be improved with parathyroidectomy. Therefore, parathyroidectomy should be recommended for patients with asymptomatic primary hyperparathyroidism. Guideline and recommendation by an international work shop on primary hyperparathyroidism has presented for the surgical indications. Non invasive localization studies including ultrasound and sestamibi scan, and intraoperative parathyroid hormone assay can achieve successful minimally invasive focused parathyroidectomy.