Acta Neurochirurgica · 7 authors, 2 centres
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This meta-analysis of 40 studies found that female patients had a significantly higher rate of postoperative diabetes insipidus after pituitary surgery, but no statistically significant gender differences were found for biochemical remission, gross total resection, or preoperative prolactin levels.
This systematic review and meta-analysis examined gender differences in outcomes after transsphenoidal resection of pituitary adenomas by analyzing 40 studies with 4989 patients. The primary finding was a significantly higher rate of postoperative diabetes insipidus in female patients compared to males, with an odds ratio of 0.40 (95% CI 0.26–0.64, P < 0.0001). No statistically significant differences were observed between genders for postoperative biochemical remission, gross total resection, or preoperative prolactin levels. The authors note that high heterogeneity was present for most outcomes, likely due to small study sizes, and that the overall certainty of evidence was low to very low according to the GRADE framework. Limitations included differing definitions of diabetes insipidus across studies and a lack of reported data on sexual hormone status. The study concludes that future research should systematically report data by gender to clarify these associations.
