Surgery often reduces symptoms of pituitary tumors. Following your post-operative instructions helps minimize your chance of complications.

Your pituitary gland is found at the base of your brain. It secrets hormones that act on many different organs throughout your body. Pituitary tumors can be cancerous or noncancerous (benign). Either type may require surgery if they’re causing symptoms.

Pituitary surgery is often effective, but it comes with some risk of complications, such as bleeding or brain injury. The risk of brain injury is usually highest if your doctor has to perform a craniotomy, where they remove part of your skull.

In this article, we look at what you can expect after your surgery.

You may need surgery if your tumor is:

  • compressing structures in your brain
  • secreting hormones
  • growing rapidly

The two main surgical techniques to treat pituitary tumors are:

Transsphenoidal surgery

The most common way surgeons remove pituitary gland tumors is with transsphenoidal surgery. This procedure involves making a small cut inside your nose and cutting through the hollow sphenoid bone behind your nose to reach your pituitary gland.

Your surgeon will likely try to remove all of the tumor. They may only remove part if removing the entire tumor could be dangerous.

Craniotomy

A craniotomy is a more invasive option to treat large or complicated tumors. It involves removing a flap of bone on one side of your skull and cutting through the thin layer of tissue covering your brain called the dura mater.

Your surgeon will work around your brain tissue to remove as much of the tumor as they can.

You’ll likely wake up from your procedure in the recovery area of your hospital or surgical center. If you had transsphenoidal surgery, your nose may be filled with gauze packing. This will be removed after 24–48 hours.

If you had a craniotomy, you’ll have bandages around your head and stitches or staples holding your incisions that will be removed about a week after your procedure.

After you wake up, you may have a catheter inserted into your bladder for at least 48–72 hours. Your healthcare team will monitor your urine, as producing an unusually high amount of urine is a common complication. They will also perform blood tests and measure your vital signs.

Typically, you’ll stay in the hospital for 3 to 5 days after transsphenoidal surgery and 5–10 days for craniotomy.

Pituitary tumor surgical risks

All surgeries come with some risk. Complication rates reported in a Swedish study among 578 people who received transsphenoidal resection were:

Craniotomy comes with a higher risk of brain injury.

You may have sinus headaches and nasal congestion for up to 2 weeks after transsphenoidal surgery. You may also have:

  • mucus discharge
  • blood clots
  • crusting around your nose

Your doctor will give you pain medications to help relieve your discomfort. Your taste and smell may be altered after your procedure, but they should return within a couple of weeks.

Most people are given hydrocortisone tablets to take after pituitary surgery. These tablets help keep your hormones in balance. You’ll need to take these until your doctor tells you it’s safe to stop.

It often takes 4–6 weeks to recover completely from pituitary surgery. During your recovery period, it’s essential to contact your doctor if you develop signs of complications such as:

  • severe headaches, especially with a high fever, light sensitivity, or a stiff neck
  • feeling very thirsty or passing a large amount of urine
  • leaking clear fluid from your nose or throat
  • loss of vision
  • loss of taste or smell that doesn’t improve over the next couple of weeks

What shouldn’t you do after pituitary surgery?

After your surgery, it’s a good idea to avoid:

  • blowing your nose for about 2 weeks
  • swimming for at least 3 months
  • driving for up to 6 months if you had a craniotomy
  • flying within 2 months

It’s essential to go to all your regular follow-up appointments after your procedure. You’ll undergo a variety of tests to monitor your recovery, such as:

Most people have follow-up visits with a specialist for the rest of their lives.

Your surgeon may recommend nasal douching starting from 1–6 weeks after your procedure to help clear out your nose.

It’s common to have low pituitary hormone levels after your surgery. You may need to take hormone replacement temporarily or permanently. Examples include:

You may need to take a desmopressin nasal spray if you develop problems regulating your blood sugar.

The outlook for pituitary surgery varies depending on factors such as:

  • the size of your tumor
  • your type of tumor
  • the type of procedure you receive

About 83% of people with the most common type of pituitary tumor, pituitary adenoma, are well with no signs of the disease at long-term follow-up.

The overall mortality rate of transsphenoidal surgery is less than 0.5%.

After surgery, some people need to take medications for the rest of their lives to regulate their hormone levels.

Pituitary surgery often improves hormone levels and reduces complications from tumors. It’s essential to attend all of your scheduled follow-ups after your surgery to monitor your hormone levels and the effectiveness of your surgery.

The chances of your procedure being successful depends on factors such as your tumor type and size. Many types of pituitary tumors have high rates of successful treatment with surgery.