Prolactin-secreting pituitary adenomas in males: transsphenoidal microsurgical treatment

Fifteen male patients with prolactin-secreting pituitary adenomas were studied before and after transsphenoidal microsurgical treatment. Loss of libido and sexual impotence were the most frequent symptoms, being present in 12. Visual defects were present in seven patients, gynecomastia was observed in four and galactorrhea was noted in three. Most of the tumours were large; only one was a microadenoma. Four patients were cured by the operation. In all the other patients the plasma levels of prolactin were significantly lowered and the visual defects corrected or lessened, but sexual impotence was not modified. No important deficiency of the pituitary gland was induced by the operation. The results indicate that in males loss of libido and sexual impotence are frequent and early manifestations of prolactinomas, and that transsphenoidal resection is a safe therapeutic approach.