Diabetes Insipidus: A Case Study

Introduction: Diabetes Insipidus (DI) is a common complication following pituitary surgery. It has been traditionally reported in the range of 5 to 15% after transsphenoidal resection of pituitary adenomas. Here we report our experience with Diabetes Insipidus following Endoscopic resection of pituitary adenomas.
Methods: We retrospectively reviewed the Stanford University Pituitary Adenoma database. Between the years 2007 and 2012 we identified 183 patients who underwent endoscopic resection of pituitary adenomas by the senior author (G.R.H). In the early postoperative inpatient period DI was diagnosed on the basis of symptomatology, urine output, osmolality, and serum sodium levels. In the outpatient setting, DI was followed by symptomatology and serum sodium levels.

The median age was 50 years (range: 18–89years). All had pathological confirmation of the diagnosis. The male to female ratio was 1:1.2. Nonfunctional pituitary adenomas represented 60% (109/183) of the tumors. Median follow-up was 36 months (range: 1week - 78 months). Three charts were missing DI follow-up data. The incidence of DI was 26% (47/180) in the early postoperative inpatient period (less than one week) and 9% (17/180) in long term follow-up. For Microadenomas, 21% (9/42) had DI in the early postop period and 9.5% (4/42) in long term follow-up. For Macroadenomas, 27% (38/138) had DI in the early postop period and 9.4% (13/138) in long term follow-up. Functional tumors and old age (>50 years) were associated with higher incidence of DI