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For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with \u2018mild\u2019 or \u2018asymptomatic\u2019 PHPT. The surgeon and the medical practitioner agree to consider that in patients with \u2018mild\u2019 or \u2018asymptomatic\u2019 disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost\/benefit ratios of surgery or survey are also still imperfectly evaluated.<\/jats:p>","DOI":"10.1530\/eje-15-0277","type":"journal-article","created":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T01:30:20Z","timestamp":1435023020000},"page":"D13-D20","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":17,"title":["Is surgery necessary for \u2018mild\u2019 or \u2018asymptomatic\u2019 hyperparathyroidism?"],"prefix":"10.1093","volume":"173","author":[{"given":"Bruno","family":"Niederle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"W\u00e9meau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2015080418004259000_173.3.D13.1","unstructured":"Niederle B Stamm L Langle F Schubert E Woloszczuk W Prager R . Primary hyperparathyroidism in Austria: results of an 8-year prospective study. World Journal of Surgery 1992 16 777\u2013782.discussion 782\u2013773 (doi:10.1007\/BF02067385)."},{"key":"2015080418004259000_173.3.D13.2","unstructured":"Hesch R. Die Konservative Therapie des Extrarenalen Hyperparathyreoidismus. Stuttgart: Schattauer Verlag, 1981"},{"key":"2015080418004259000_173.3.D13.3","doi-asserted-by":"crossref","unstructured":"Hasse C Sitter H Bachmann S Zielke A Koller M Nies C Lorenz W Rothmund M . How asymptomatic is asymptomatic primary hyperparathyroidism? Experimental and Clinical Endocrinology & Diabetes 2000 108 265\u2013274. (doi:10.1055\/s-2000-7754).","DOI":"10.1055\/s-2000-7754"},{"key":"2015080418004259000_173.3.D13.4","doi-asserted-by":"crossref","unstructured":"Niederle B & Riss P. Metabolic Complications of Primary Hyperparathyroidism. 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