Transsphenoidal surgery for prolactinomas in male patients: a retrospective study

• Published in: Asian journal of andrology 2023-01, Vol.25 (1), p.113-118
• Main Authors: Su, Wei-Jie, Cai, Hong-Cai, Yang, Guo-Chen, He, Ke-Jun, Wu, Hong-Lin, Yang, Yi-Bing, Tang, Hong-Xing, Yang, Li-Xuan, Deng, Chun-Hua
• Format: Article
• Language: English
• Subjects: Cabergoline; Erectile dysfunction; Erectile Dysfunction - epidemiology; Erectile Dysfunction - etiology; erectile dysfunction; prolactinomas; sexual dysfunction; transsphenoidal surgery; Humans; Male; Medical research; Medicine, Experimental; Original; Pituitary gland; Pituitary Neoplasms - complications; Pituitary Neoplasms - pathology; Pituitary Neoplasms - surgery; Prolactinoma - complications; Prolactinoma - surgery; Retrospective Studies; Risk factors; Sexual disorders; Sexual Dysfunction, Physiological - complications; Surgery; Surgical outcomes; Testosterone; Tumors
• ISSN: 1008-682X; 1745-7262; 1745-7262; 1008-682X
• DOI: 10.4103/aja202233

Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone