Patient Guide · Pituitary Surgery
Transsphenoidal Resection of a Pituitary Tumour
The pituitary gland is a small gland at the base of the brain that controls many of the body's hormones. This guide explains what to expect from microscopic transsphenoidal surgery — from why it's recommended through to recovery and follow-up.
The basics
Why surgery might be recommended
A pituitary tumour can affect health by producing excessive hormones, reducing normal pituitary function, or pressing on nearby structures such as the optic nerves. Surgery may be recommended when a tumour threatens vision, produces excessive hormones, has bled or swollen suddenly, or has not responded to medical treatment. Most pituitary tumours are benign, and the aim is to remove as much of the tumour as safely possible while preserving normal gland function and vision.
Who looks after you
Your multidisciplinary team
Neurosurgeon
Assesses the tumour and performs the operation.
Endocrinologist
Assesses pituitary hormone function before and after surgery, and advises on hormone-replacement medication.
Ophthalmologist
Assesses your eyesight, including visual acuity and visual fields — particularly important when the tumour presses on the optic nerves.
Anaesthetist
Assesses your general medical fitness, administers the general anaesthetic, and monitors you throughout the operation.
What to expect
Your surgical journey
Before your operation
Blood tests, pituitary hormone tests, MRI, formal visual-field testing, and assessment by the endocrinologist, ophthalmologist and anaesthetist. Bring a complete list of your medications — some may need to be temporarily stopped, and steroid medication must never be stopped suddenly without advice.
During the operation
Performed under general anaesthesia through the nose, with no visible incision. The surgeon creates a corridor through the sphenoid sinus to reach the pituitary gland, then uses an operating microscope to remove the tumour while preserving the normal gland, optic nerves and blood vessels. Two nasal packs are placed at the end of surgery.
Immediately after
You are monitored closely for vision, blood pressure, fluid balance, blood sodium and pituitary hormone function. The nasal packs are usually removed after about 48 hours. Headache, a blocked nose, and reduced taste or smell are common in this period.
Going home
Most patients stay in hospital for three to four days, depending on vision, hormone levels, and how the nose and wound are healing. Before discharge the team reviews your neurological condition, vision, fluid balance, and any hormone-replacement needs.
Follow-up
Clinic review at one to two weeks, with endocrinology and ophthalmology input as needed. A repeat MRI is usually arranged at two to three months to assess how much of the tumour was removed and whether further treatment is needed.
Being informed
Possible risks and complications
Nasal and local
Nasal bleeding, sinus infection, crusting or blockage, and temporary reduction in smell or taste. Usually settle with time.
Hormonal
Temporary or permanent hormone deficiency, diabetes insipidus, and low blood sodium — all monitored closely and treated if they occur.
Serious but rare
CSF leakage, meningitis, damage to the optic nerves or blood vessels, stroke, and very rarely death. Your surgeon will discuss the risks specific to your tumour.
When to worry
Seek urgent medical attention
Contact your surgical team or the Emergency Department if you develop
- Clear, watery fluid continuously leaking from the nose, or a salty fluid running down the throat
- Sudden deterioration in vision, or new double vision
- Severe or increasing headache, with repeated vomiting
- Fever, neck stiffness, increasing drowsiness or confusion
- Severe thirst with excessive urine production, or passing very little urine despite drinking
- Severe weakness, dizziness or collapse
What to remember
Key clinical pearls
- 1Most pituitary tumours are benign — surgery is about relieving pressure and restoring hormone balance, not treating cancer.
- 2Complete tumour removal cannot always be guaranteed — some tumours grow close to critical vessels and nerves that must be preserved.
- 3Continuous clear fluid from the nose is never ordinary mucus after this surgery — it needs urgent assessment for a CSF leak.
- 4Low blood sodium can develop days after discharge, not just in hospital — know the symptoms and seek help if they appear.
- 5Never stop steroid or hormone-replacement medication suddenly — always check with your endocrinology or neurosurgical team first.
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