個案報告:腦下垂體腺瘤併高泌乳激素血症與男性勃起功能障礙
盧顥文、童敏哲、許兆畬、殷約翰、戴浩平、謝肇新
陳祥來、黃鐘銘、翁瑋駿、黃立華、李毅彥
童綜合醫院 外科部 泌尿科
Pituitary gland adenoma with hyperprolactinemia and male erectile dysfunction-A case report
Hao-Wen Lu , Min-Che Tung, Chao-Yu Shu, Jue-Hawn Yin, Siu-San Tse, Hao-Ping Tai,
Hsiang-Lai Chen, Zhon-Min Huang, Wei-Chun Weng, Li-Hua Huang, I-Yen Lee
Divisions of Urology, Department of Surgery,Divisions of Urology
Purpose: Prolactinoma is the most common type of pituitary adenoma and can cause hyperprolactinemia which is the most common cause of male sexual dysfunction. However endocrinopathy is the rarest of causes of male sexual dysfunction. To check routine serum prolactin level in the initial evaluation of erectile dysfunction has been questioned. Though check prolactin level only in case of low testosterone level is generally accepted. The first choice of treatment in hyperprolactinemia induced Impotence is bromocriptine. It can reduce the level of serum prolactin level together with improvement of sexual libido and potency
Case report: We report a case who suffered from erectile dysfunction for half one year. Laboratory data revealed severe hyperprolactinemia. Pituitary gland adenoma was found on magnetic resonance imaging. Neurosurgeon arrange transsphenoidal endoscopic pituitary tumor excision for this patient, and post operation follow up showed reduced serum prolactin level to near normal range. However, erectile dysfunction was still noticed. After combination of bromocriptine and testosterone administration, he claim great improvement of erectile function
Conclusions: In case of hyperprolactinemia with persist hypogonadism, combination treatment should be considered.