[Hyperprolactinemia in the male: clinical aspects and therapy]

Fifty-seven male patients with hyperprolactinemia have been investigated. Macroadenomas were found in 49 patients of whom 24 had received pituitary surgery before elevated PRL levels were discovered. In 8 patients radiology of the pituitary fossa revealed either evidence of microadenoma or a completely normal sella turcica. Prolactin levels ranged from 582 to 498 000 microU/ml. All patients with macroprolactinomas, including those who had undergone previous surgery, had PRL levels above 5000 microU/ml. Disturbances of libido and sexual potency were prevalent in the majority of patients, less frequently accompanied by gynacecomastia and galactorrhea. However, visual disturbances were the reason for the first visit to the doctor in the majority of patients. Pituitary surgery led to improvement of visual field defects, though prolactin levels were never normalized. Postoperative radiotherapy had no significant influence on PRL levels. In contrast, bromocriptine therapy led, in the majority of patients, not only to improvement of hypogonadal symptoms but also to normalization of PRL levels.