Mainstay treatment of primary hyperparathyroidism is

The mainstay of treatment for PHPT is surgery. All symptomatic patients and asymptomatic patients with bone resorption or hypercalcemia are offered surgical intervention.Where a single adenoma ie one gland) has been confidently identified by radiological means, a minimally invasive parathyroidectomy may be offered. Else a three and a half-gland parathyroidectomy or a four gland parathyroidectomy and autotransplantation should be performed.All other options are pa of medical management.Medical management is warranted in patients who are deemed unfit or who have contraindications to surgical intervention, in patients with failed surgical intervention or in the long-term management of parathyroid carcinoma.Ref: Bailey and Love 27e pg: 829