[Hyperprolactinemia and prolactinomas. Results of surgical and drug therapy]

185 patients with hyperprolactinaemia and prolactinoma were evaluated in a retrospective investigation. 128 patients were treated surgically whereby the prolactin serum level in 47% of the macroprolactinoma and 60% of the microprolactinoma patients was normalised (prolactin less than 25 ng/ml, no radiological evidence of tumor). Of those patients in whom the operation was less successful, a normal prolactin level could be achieved in 77% by additional therapy with dopamine agonists. Of 57 patients handled exclusively with drugs, the prolactin level was normalised by dopamine agonists in 78%. A small number of patients from both groups did not show a satisfactory fall in the prolactin level despite the use of markedly higher doses of dopamine agonists. During dopamine agonist therapy progressive tumor enlargement was detected radiologically in a previously operated patient.