Intraoperative parathyroid hormone monitoring in primary hyperparathyroidism; resolving controversies and debates

Intraoperative parathyroid hormone monitoring (IPM) has been increasingly considered as a valuable adjunct in surgery for primary hyperparathyroidism (PHPT). In view of the attributed extra cost and time, its routine use has been debated. Similarly, controversies have encompassed various aspects of IPM implementation. This article will display the up to date evidence relating to IPM use in different clinical scenarios, discuss the pros and cons of its controversial technical aspects, highlight the relevant recommendations and identify areas which need further research. The aim of this review is to help surgeons deciding whether IPM is needed in a particular PHPT patient and what is the optimal protocol to be followed in that patient.