Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Video

Updated: Aug 26, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Surgery as a first-line option for prolactinomas.

¹Surgical Director, Pituitary Center & Center for Minimally Invasive Skull Base Surgery, Cedars-Sinai Medical Center, Los Angeles.

Expert Review of Endocrinology & Metabolism

|October 6, 2022

Summary

For prolactinomas, a surgery-first approach may offer higher cure rates and lower long-term costs compared to dopamine agonists. This strategy is recommended for select cases, prioritizing skilled surgical intervention.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Early Findings from the Multicenter RAPID Consortium on Papillary Craniopharyngiomas.

Journal of neurological surgery. Part B, Skull base·2026

Same author

Microstimulation of the human dopaminergic midbrain enhances outcome-related happiness and reduces loss seeking.

bioRxiv : the preprint server for biology·2026

Same author

Comparison of clinical outcomes in adamantinomatous and papillary craniopharyngioma: a baseline analysis before the targeted therapy era.

Neurosurgical focus·2026

Same author

Frailty and postoperative outcomes following craniopharyngioma resection: a multicenter Registry for Adenomas of the Pituitary and Related Disorders analysis.

Neurosurgical focus·2026

Same author

Risk factors for postoperative cerebrospinal fluid leak following endoscopic transsphenoidal surgery for craniopharyngioma: a multicenter cohort study with a contemporary surgeon practice survey.

Journal of neuro-oncology·2026

Same author

Adamantinomatous craniopharyngioma: outcomes from a US multicenter registry cohort (RAPID consortium study).

Journal of neurosurgery·2026

Area of Science:

Endocrinology
Neurosurgery
Oncology

Background:

Dopamine agonists (DAs) are the traditional first-line treatment for prolactinomas.
Surgery is typically reserved for refractory cases or medication intolerance.
This established approach may not be optimal for all patients.

Purpose of the Study:

To review prolactinoma epidemiology, biology, and treatment outcomes.
To propose a 'surgery-first' treatment paradigm for a subset of prolactinomas.
To evaluate outcomes, costs, and morbidities of different therapeutic options.

Main Methods:

Comprehensive review of existing literature on prolactinoma treatments.
Analysis of data on treatment outcomes, associated costs, and morbidities.

Keywords:

Prolactin bromocriptine cabergoline cavernous sinus cost dopamine agonist knosp grade prolactinoma side effects transsphenoidal surgery

More Related Videos

Surgical Treatment of an Endolymphatic Sac Tumor

Surgical Treatment of an Endolymphatic Sac Tumor

Published on: May 26, 2023

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

Related Experiment Videos

Last Updated: Aug 26, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Surgical Treatment of an Endolymphatic Sac Tumor

Surgical Treatment of an Endolymphatic Sac Tumor

Published on: May 26, 2023

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

Development of a 'surgery-first' treatment algorithm based on evidence.

Main Results:

Transsphenoidal surgery is a viable first-line option for select micro- and macroprolactinomas without significant cavernous sinus invasion.
Dopamine agonists can be used as secondary therapy post-surgery or for giant tumors.
A surgery-first approach can lead to high cure rates and reduced long-term healthcare costs.

Conclusions:

A 'surgery-first' strategy for appropriate prolactinoma patients can improve cure rates and minimize long-term morbidities.
This approach necessitates experienced pituitary surgeons for optimal outcomes.
It offers a potential alternative to primary medical management, reducing costs and DA dependency.