[Should plasma prolactin assay be routinely performed in the assessment of erectile dysfunction? Report of a series of 445 patients. Review of the literature].
OBJECTIVE
To define the value of plasma prolactin assay in the assessment of erectile insufficiency.


METHODS
Plasma prolactin assay (radioimmunoassay) was performed in 445 patients presenting with erectile insufficiency (mean age 52.5 years).


RESULTS
9 patients (2%) presented plasma prolactin levels greater than 25 ng/ml and 4 (0.9%) of them had levels higher than 35 ng/ml. Eight of these 9 patients were taking hyperprolactinaemic drugs. The aetiology remained unclear in 1 patient, but the pituitary gland was normal on CT scan.


METHODS
In the population of men with erectile insufficiency, 2.7% of subjects have plasma prolactin levels greater than 20 or 25 ng/ml. 1.3% have levels greater than 35 or 40 ng/ml and 0.6% present pituitary tumours. In the case of pituitary tumours responsible hyperprolactinaemia and erectile insufficiency: 1) plasma prolactin is greater than 30 ng/ml in 90% of cases and greater than 50 ng/ml in 83% of cases; 2) total plasma testosterone is less than 3 ng/ml in 88% of cases and less than 4 ng/ml in 96% of cases; 3) libido is decreased in 90% of cases.


CONCLUSIONS
The prevalence of hyperprolactinemia and pituitary tumours in the population of men with erectile insufficiency is low. Moreover, certain criteria are suggestive of hyperprolactinemia, especially when it is secondary to a pituitary tumour. Consequently, routine plasma prolactin assay is not justified. This assay should only be performed when libido is impaired, total plasma testosterone is decreased or when the patient presents certain signs such as headache, gynaecomastia or visual disturbances.
Delavierre
D
D
Service d'Urologie-Andrologie, CHR La Source, Orléans, France.
Girard
P
P
Peneau
M
M
Ibrahim
H
H
D007172:Erectile Dysfunction / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011388:Prolactin / Q000097:blood*
D011388:Prolactin