Does surgery for hyperprolactinemia have a high cure rate?

Does surgery for hyperprolactinemia have a high cure rate? Recently, I learned about hyperprolactinemia from a friend's discussion. I really want to know what treatments there are for hyperprolactinemia. I believe that many friends are like me and want to know about the treatments for hyperprolactinemia. So I went online to look up some methods for treating hyperprolactinemia, hoping to help you.

1. Traditional Chinese medicine believes that the etiology and pathogenesis of this disease are relatively complex, but in principle it can be divided into two categories: deficiency and excess. Deficiency is caused by liver and kidney deficiency, insufficient essence and blood, and an empty blood sea. Amenorrhea occurs when there is no blood to flow down. Weak qi and blood, and insufficient kidney qi causes milk to overflow. Excess is caused by liver depression and qi stagnation, blood stasis and phlegm obstruction, and blocked meridians, so that menstrual blood has to flow down; or liver meridians are stagnant and heat is stagnant, and the drainage is abnormal, forcing milk to overflow. Due to insufficient endowment, kidney qi is not strong, essence is not full, liver blood is insufficient, Chong and Ren are not nourished, and there is no way to transform into menstrual blood; or sexual fatigue and long-term illness lead to kidney essence depletion, liver blood deficiency, lack of essence and blood, and the source is cut off, Chong and Ren are deficient, and there is no blood to flow down the uterus, resulting in amenorrhea.

As the Medical Biography states: "Menstruation is entirely dependent on kidney water. When kidney water is deficient, menstrual fluid dries up day by day." Or if kidney yang is deficient, yang qi cannot reach the body, yang deficiency causes cold, and cold blood stagnation; or if kidney yang deficiency cannot warm and move the spleen and consolidate, and the body cannot absorb milk, milk can be seen overflowing as it is transformed. If the spleen and stomach are weak, or if the diet is overworked, improper medication, or excessive worry damages the heart and spleen, and the blood is insufficient; or if serious illness, long-term illness, abortion, miscarriage, etc. cause blood loss, or breastfeeding for too long and too long damages qi and consumes blood, the Chong and Ren meridians are deficient, the blood sea is empty, and there is no blood to be discharged, resulting in amenorrhea.

As the Lanshi Mizang says: "Women's spleen is in need for a long time, or their body is weak and their qi and blood are weak, which leads to the cessation of menstruation." If the seven emotions hurt the internal organs, the liver qi is stagnant, the qi is stagnant and the blood is stagnant, the Chong and Ren meridians are blocked, the uterine vessels are blocked, and the menstruation is blocked, so it leads to amenorrhea; or anger hurts the liver, the liver fire is hyperactive, and the discharge is too much, forcing the milk to overflow. The Taisheng Xinfa says: "The anger of the liver meridian rushes up, and the breasts swell and overflow." In addition, obese people have a lot of phlegm and dampness, which block the meridians; or the spleen yang fails to function, the dampness gathers into phlegm, and the fat phlegm and dampness block the Chong and Ren meridians, the uterine vessels are blocked and the menstruation does not work.

"Essentials of Gynecology" said: "Fat and white people who have amenorrhea and menstruation must be due to the obstruction of damp phlegm and lipid membrane." In summary, the occurrence of this disease involves deficiency of the liver, spleen, and kidney, resulting in deficiency of essence, qi, and blood, or due to obstruction of qi, blood, and phlegm.

2. Treatment of the cause and primary disease

Such as eliminating adverse mental stimulation, stopping the use of HPRL-inducing drugs, and actively treating primary diseases such as pituitary tumors, hypothyroidism, Cushing's disease, etc. Anti-prolactin-bromocriptine therapy

Bromocriptine is a semi-synthetic ergot alkaloid derivative and a dopamine receptor agonist. It can promote the synthesis and secretion of PRL-IH and inhibit the synthesis and release of PRL through the receptor mechanism. It also directly acts on pituitary tumors and PRL cells to curb tumor growth and inhibit the secretion of PRL, GH, TSH and ACTH.

Bromocriptine therapy is suitable for all types of HPRL and is also the first choice for pituitary adenomas (micro/macroadenomas), especially for young infertile women who are looking forward to having children. The dose is 2.5-7.5 mg/d, taken orally. Other anti-prolactin drugs include: levodopa, octahydrobenzoquinoline (cv205-502), vitamin b6, etc. For details, please refer to the anti-prolactin section in the endocrine therapy chapter.

3. Ovulation induction treatment

It is suitable for patients with HPRL, anovulatory infertility, and those who cannot successfully ovulate and become pregnant after simple bromocriptine treatment. That is, a comprehensive therapy with bromocriptine as the main drug and other ovulation-promoting drugs: ① bromocriptine-cc-hcg; ② bromocriptine-hmg-hcg; ③ gNRH. Pulse therapy-bromocriptine, etc. Comprehensive therapy can save anti-prolactin, shorten the treatment cycle and increase the ovulation rate and pregnancy rate.

4. Surgical treatment

It is suitable for patients with giant adenomas that present compression symptoms, as well as patients with drug-resistant tumors, patients who are unresponsive to bromocriptine treatment, and patients with septicomas that secrete multiple pituitary hormones.

The current transsphenoidal microsurgery is safe, convenient, and easy to perform, and its efficacy is similar to that of bromocriptine therapy. The use of bromocriptine before and after surgery can improve the efficacy. The disadvantages of surgery are: if the pituitary tumor has no obvious capsule and unclear boundaries, the surgery is not easy to be thorough or may cause damage, resulting in cerebrospinal fluid nasal fistula and secondary hypopituitarism.

5. Radiation therapy

It is suitable for non-functional tumors of the HP system and those who have not responded to drug and surgical treatment. Irradiation methods include: deep X-ray, 60Co, α particles and proton rays. Isotope 90yttrium, 198gold pituitary implantation, etc.

After reading the above content, I think everyone must have understood the treatment of hyperprolactinemia. I hope everyone can pay attention to this disease. If you find any signs of hyperprolactinemia, you must go to the hospital for diagnosis and active treatment.