The aim of the present investigation was to study first signs of disease, effectiveness of the cabergoline treatment for prolactinomas in men. We studied 53 patients with pituitary adenomas. Patients are divided into 2 groups depending on size of the tumor: group I - microadenomas (11), group II - macroadenomas (42). PRL level before treatment in group I on average was 5890±7.4 mU/l; in group II - 29790±18.2 mU/l. Testosterone level in group I was 9.45±0.6 nmol/l; in group II - 6.25±0.2 nmol/l. From 35 patients studied sexual dysfunction and libido reduction (66%), 14 had visual disturbances (27%), 4 had gynecomastia (7%). PRL concentration, cerebrum magnetic resonance imaging and oftalmological study was defined for all patients during investigation. All patients received in medium dose 2.5 mg per week during 6 months.
Results: PRL level significantly reduced in group I to 437±8.4 mU/l (P<0.001), in group II to 790±6.3 mU/l (P<0.005). Testosterone level significantly increased in group I to 19.8±0.04 nmol/l (P<0.002), in group II to 16.6±0.08 nmol/l (P<0.001). Positive dynamics of the tumors volume is noted in 10 patients in group I (91%): 8 men had reduction of the size of adenoma (more then 30%), and adenoma has disappeared in 2 men. No dynamics observed in 1 man (9%). Positive dynamics of the tumors volume is noted at 38 patients in II group (90.4%): adenoma has reduced in 35 men, and disappeared in 3 men. No dynamics observed in 5 men (9.4%). All 35 patients with sexual dysfunction and libido reduction had libido einforcement, erectile function is normalized with positive effect on sexual life.
Conclusion: The first clinical manifestations of prolactinomas in men are the disturbances of sexual function. Cabergoline is the most effective drug (of available in present) for the treatment of prolactinomas: the individual dose normalizes PRL level in 100% of events, in 82% of them it promotes the reduction of the sizes of tumors up to its disappearances.
01 - 05 Apr 2006
European Society of Endocrinology