Under what circumstances may surgery for galactorrhea be necessary?

In rare circumstances, surgery may be considered for the treatment of galactorrhea if medications and conservative management measures have failed to resolve the condition and the underlying cause is determined to be a benign prolactinoma (prolactin-secreting pituitary tumor). Surgery is typically reserved for cases where medical therapy has not effectively controlled symptoms, the prolactinoma is large or shows signs of growth, or when vision is impaired.

The surgical approach used to treat galactorrhea caused by a prolactinoma is called trans-sphenoidal surgery. In this procedure, the surgeon accesses the pituitary gland through the nose and creates a small opening in the bone covering the sella turcica (the bony structure that houses the pituitary gland). Using specialized instruments, the surgeon carefully removes all or part of the prolactinoma, reducing its size and alleviating pressure on surrounding structures.

Surgery for galactorrhea is considered a safe and effective treatment option for selected individuals, with high success rates in controlling symptoms and normalizing prolactin levels. It is essential that experienced neurosurgeons and endocrinologists collaborate to determine the most appropriate course of action for each case. Long-term monitoring and follow-up care are generally necessary after surgery to assess prolactin levels and evaluate the effectiveness of the intervention.