Predictors of the Outcome of Transsphenoidal Surgery for Prolactin-Secreting Pituitary Adenomas*

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Abstract
Sixty-seven women who underwent transsphenoidal resection of PRL-secreting pituitary adenomas between 1976 and 1979 were separated into categories according to the manner of their clinical presentation. Forty-one had oral contraceptive-related onset of amenorrhea-galactorrhea, 5 had pregnancy-related onset of amenorrhea-galactorrhea, 5 had primary amenorrhea, and 16 had the spontaneous onset of amenorrheagalactorrhea unrelated to estrogen use. Surgical success, defined as the resumption of regular menses and normalization of serum PRL concentration, was achieved in 54% of those with estrogenrelated onset of amenorrhea-galactorrhea compared with 19% in the other group. The analysis of multiple preoperative features, including clinical classification, age, preoperative PRL concentration, and duration of amenorrhea-galactorrhea by logistic regression, demonstrated that the clinical classification was the most important factor in predicting the outcome of transsphenoidal surgery. It should be a prime consideration in the selection of therapy for PRL-secreting adenomas.