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depending on job demands and hormonal status."},"complication_rate_pct":{"min":10,"max":25,"unit":"percent","qualifier":"Any complication within 90 days, including transient diabetes insipidus, hyponatremia, new hormone deficiency; serious ones under 3%."},"contraindications":["Unfit for general anesthesia due to severe cardiopulmonary disease (relative)","Active sinonasal or sphenoid infection (relative, usually treated first)","Uncorrected bleeding disorder or unavoidable anticoagulation"],"days_in_clinic":{"min":2,"max":5,"unit":"nights","qualifier":"Typical hospital stay after uncomplicated transsphenoidal resection, with monitoring of sodium, urine output and hormones."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":4,"max":8,"unit":"weeks","qualifier":"Light walking early; avoid heavy lifting, straining and strenuous exercise until cleared by the 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effect","Visual field loss from optic chiasm compression","Growth hormone-secreting adenoma (acromegaly)","ACTH-secreting adenoma (Cushing disease)","Prolactinoma that is resistant to or intolerant of medical therapy","Pituitary apoplexy with neurological or visual deterioration","Tumor growth on surveillance imaging"],"main_risks":["Temporary or permanent pituitary hormone deficiency","Diabetes insipidus (usually transient)","Hyponatremia (delayed, 5–10 days after surgery)","CSF leak and meningitis","Nasal crusting, congestion, sinusitis or smell changes","Bleeding","Visual worsening or injury to optic nerves (rare)","Carotid artery injury (rare)","Anesthesia-related risks"],"pain":"Mild to moderate; headache and nasal discomfort or congestion are common for several days and are usually controlled with simple analgesics. There are no external incisions.","preparation":["Pituitary MRI, sometimes skull base and sinus CT","Full pituitary hormone panel and endocrine assessment","Formal visual field and acuity testing","Preoperative blood tests and anesthesia assessment","Perioperative steroid cover planned by endocrine team if needed","Fasting before general anesthesia","Review medications and blood thinners with care team","Stop smoking"],"recovery_timeline":[{"phase":"Hospital stay (days 0–5)","description":"Monitoring of sodium, urine output, vision and any nasal CSF leak; early mobilization.","restrictions":["Do not blow the nose","Avoid straining"]},{"phase":"Early home recovery (weeks 1–2)","description":"Headache, nasal congestion and fatigue improve; saline nasal rinses as advised. Report clear nasal fluid, thirst or severe headache.","restrictions":["No nose blowing","Avoid heavy lifting and bending","Sneeze with the mouth open"]},{"phase":"Weeks 3–6","description":"Return to normal daily activities and desk work; nasal healing and crust clearance.","restrictions":["Avoid strenuous exertion until cleared"]},{"phase":"Months 2–4","description":"Hormone replacement is adjusted and MRI and vision are reassessed.","restrictions":[]}],"rehabilitation_days":{"min":14,"max":42,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated endoscopic transsphenoidal surgery; no formal rehabilitation program is usually required."},"result_longevity":"Many tumors are controlled long term after complete resection, but recurrence is possible, depending on tumor type and extent of resection, so long-term imaging and hormone surveillance is advised.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Repeat surgery for residual or recurrent tumor, or CSF leak repair, within about 5 years."},"scars":"No visible scar with the endoscopic transnasal approach, because the tumor is reached through the nostril and sphenoid sinus.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"A single operation; follow-up checks are not counted as treatment sessions."},"stages":[{"code":"surgery","label":"Endoscopic transsphenoidal tumor resection","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of the procedure."}}],"qualifier":"Standard endoscopic transsphenoidal resection in one stage."},"success":{"metric":"Gross total resection of non-functioning macroadenoma","value":70,"unit":"percent of patients","horizon":"3 months on postoperative MRI","population":"Adults with non-functioning macroadenoma, endoscopic transsphenoidal surgery","evidence_status":"limited"},"techniques":[{"name":"Endoscopic endonasal transsphenoidal resection","suits_whom":"Most pituitary adenomas, including macroadenomas and those with suprasellar extension.","recovery":"Typically 2–5 nights in hospital and return to desk work in 2–6 weeks."},{"name":"Microscopic transsphenoidal (sublabial or transnasal) resection","suits_whom":"Smaller adenomas and microadenomas confined to the sella.","recovery":"Similar to the endoscopic approach."},{"name":"Transcranial (craniotomy) approach","suits_whom":"Rare large tumors with extensive lateral or suprasellar extension that cannot be reached transnasally.","recovery":"Longer hospital stay and recovery."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Operating time for a standard endoscopic transsphenoidal resection of an uncomplicated adenoma."},"initial_assessment_documents":["Pituitary MRI report and images","Pituitary hormone blood test results","Visual field test report","Neurology or endocrinology consultation notes","Previous pituitary surgery or radiotherapy reports (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 7–14 days, including 2–5 hospital nights. Endocrine and MRI follow-ups usually done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that a steroid plan is in place before discharge, because pituitary surgery may require steroid replacement","scope":"procedure","source":{"url":"https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/endoscopic-transsphenoidal-pituitary-surgery","host":"uclh.nhs.uk","quote":"Steroid plan in place (see Steroid medication).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that follow-up with endocrinology and neurosurgery is arranged before discharge","scope":"procedure","source":{"url":"https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/endoscopic-transsphenoidal-pituitary-surgery","host":"uclh.nhs.uk","quote":"Follow up plan with endocrinology and neurosurgery in place.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that blood testing is 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quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Vision 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