ABSTRACT
Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone <2.3 ng ml-1 was an independent predictor of improvement in erectile dysfunction. In conclusion, our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma. The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.
Subject(s)
Humans , Male , Prolactinoma/surgery , Erectile Dysfunction/etiology , Retrospective Studies , Sexual Dysfunction, Physiological/complications , Testosterone , Pituitary Neoplasms/pathologyABSTRACT
Objective To investigate the clinical factors influencing survival prognosis in patients with supratentorial malignant glioma (MG). Methods A total of 194 patients with MG,admitted to our hospital from January 2004 to December 2009, were chosen in our study; anaplastic astrocytoma (AA) was noted in 120 patients and glioblastoma multiforme (GB) was noted in 74 patients.Their survival status was followed-up.Survival related statistics were calculated using the Kaplan-Meier method,and differences between survival curves were analyzed by the log-rank test.The interaction of each prognostic factor and their effect on overall survival (OS) and progression-free survival (PFS) were analyzed with the Cox proportional hazards model. Results The median PFS and OS in AA patients were 18 and 21 months,and those in GB patients were 10 and 12 months.When PFS and OS were used as endpoints,AA patients lived longer than GB ones, while patients ≤ 40 years old lived longer than those ＞40 years old; patients with Karnofsky performance status (KPS) scored 80-100 had longer survival than those with KPS scored 60-70; patients with preoperative seizure enjoyed the same situation as compared with those without preoperative seizure. Both univariate and multivariate Cox analyses confirmed that independent influencing factors were age,KPS scores,grade of pathology and appearance of preoperative seizure; patients with young age, high KPS scores, low grade of pathology and preoperative seizure had longer PFS and OS than those without. Conclusion Young age,high KPS scores,low grade of pathology and preoperative seizure are protective prognostic factors in patients with MG,while gender,tumor size,tumor location,and extent of resection have no prognostic significance; the prognostic significance of contrast - enhancing is uncertain.