Retrograde ejaculation and sexual dysfunction in men with <i>diabetes mellitus</i>: a prospective, controlled study

Fedder, Jens; Kaspersen, Maja Døvling; Brandslund, Ivan; Højgaard, Astrid Ditte

doi:10.1111/j.2047-2927.2013.00083.x

Cited by 68 publications

(63 citation statements)

References 15 publications

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“…There are no studies comparing the rates of RE in Type 1 vs Type 2 diabetes mellitus. Men with RE tend to have had a diagnosis of diabetes mellitus for longer than those without RE (20 years vs 13 years) 3 . This implies that the autonomic neuropathy of diabetes associated with retrograde ejaculation tends to be a late presenting feature.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus

Kam

Tsang

Chalasani

2017

Urology Case Reports

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A 19 year old presented with a progressive decline in ejaculate volume over 2 weeks, followed by a complete absence of ejaculate emission. A post-ejaculatory urine specimen demonstrated spermatozoa confirming a diagnosis of retrograde ejaculation. Investigations revealed a raised blood glucose level of 24.5 mmol/L and HbA1c >15%, with positive tests for anti-GAD antibodies and anti-IA2 antibodies consistent with a diagnosis of Type 1 diabetes mellitus. Retrograde ejaculation in diabetes is associated with autonomic neuropathy and is a late feature of the disease. This case is unique with retrograde ejaculation being the primary presenting symptom of Type 1 diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus

Kam

Tsang

Chalasani

2017

Urology Case Reports

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“…Among the 825 remaining semen analyses associated with a PEU test, only the first analysis was selected for each patient, leaving 632 patients. We then excluded 28 patients because of incomplete records (missing history and/or ultrasound), 58 patients because of obstructive or non-obstructive azoospermia, as well as 139 patients who presented known causes or risk factors for retrograde ejaculation or low semen volume: hormonal causes (low androgen level, hyperprolactinemia), previous pelvic and retroperitoneal surgery, reduced secretion from one (absent) or both (utricle cyst) seminal vesicles, presence of a neurological deficit (multiple sclerosis), diabetes, or pharmacological treatments (antihypertensive agents, alpha-receptor blockers, antipsychotics, antidepressants) [10, 15, 17–19]. All previous inclusion criteria were used for selecting patients with retrospective low semen volume (< 2 mL) and prospective patients with normal semen volume (≥ 2 mL).…”

Section: Methodsmentioning

confidence: 99%

“…The use of a retro-ejaculatory index (R-ratio), which expresses the total number of sperm recovered in PEU as a percentage of the total number of sperm found in both semen and PEU, has been suggested to define PRE [8, 13, 14]. But none of these studies indicate a specific threshold above which PRE must be considered [15]. …”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

et al. 2017

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In non-azoospermic patients with low semen volume (LSV), looking for partial retrograde ejaculation (PRE) by searching sperm in the postejaculatory urine (PEU) is required. The use of a retro-ejaculatory index (R-ratio) was suggested to define PRE, but none of the studies indicated a specific threshold above which PRE must be considered. Our objective was to propose a threshold value for the R-ratio as indicative of PRE in patients with LSV selected to be devoid of any known causes or risk factors for retrograde ejaculation or LSV. Among our data base (2000–2009) including 632 patients with PEU, 245 male patients from infertile couples who had had a first semen analysis with LSV (< 2mL) and a second semen analysis associated with PEU, were selected on the previous criteria. A prospective control group was randomly constituted (2007–2008) of 162 first consulting male patients from infertile couples, with a normal semen volume (≥ 2mL) on a first semen analysis and who accepted to collect PEU with their usual second semen analysis, selected on the previous criteria. To define an R-ratio threshold indicative of PRE, we used a ROC curve analysis and a regression tree based on a classification and regression tree (CART) algorithm. Of the 245 LSV patients, 146 still presented low semen volume (< 2 mL) on the second semen analysis. From the use of the CART algorithm, two low (1.5% and 2.8%) and two high R-values (7.1% and 8.3%) were defined, according to the lower reference limit for semen volume of 2.0 mL (WHO 1999) or 1.5 mL (WHO 2010) respectively. As only one or no patient with normal semen volume was observed above the two high R-values, we suggest an R-value higher than the range of [7.1–8.3]% as indicative of PRE until confirmation by a prospective multicenter study.

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“…In couples presenting with retrograde ejaculation refractory to medical treatment, the first choice of fertility treatment should be assisted reproductive technology (ART) using rapidly purified spermatozoa retrieved from post-ejaculatory urine [4, 5]. However, due to its high osmolarity and low pH, urine is cytotoxic to spermatozoa [6–8].…”

Section: Introductionmentioning

confidence: 99%

Successful pregnancies and healthy live births using frozen-thawed sperm retrieved by a new modified Hotchkiss procedure in males with retrograde ejaculation: first case series

Philippon¹,

Karsenty

Bernuz

et al. 2015

Basic Clin Androl

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BackgroundIn couples presenting with retrograde ejaculation refractory to medical treatment, the first choice of fertility treatment should be Assisted Reproductive Techniques using rapidly purified spermatozoa retrieved from post-ejaculatory urine. The Hotchkiss technique and modified variants are simple and efficient for retrieving sperm from the bladder. We developed a new protocol, including a novel modified Hotchkiss technique involving sperm cryopreservation.The aim was to study the pregnancy rate and birth rate achieved by intra cytoplasmic sperm injection (ICSI) using frozen-thawed sperm retrieved from the bladder with this novel modified Hotchkiss technique in patients with refractory retrograde ejaculation.ResultsIn this descriptive retrospective, single-center study, we analyzed the local database of all patients who banked sperm at the CECOS Laboratory Biology of Reproduction of La Conception University Hospital, Marseille, France, between 2004 and 2014.A total of 2171 patients banked sperm during this time, including 63 patients with retrograde ejaculation, of whom ten patients banked sperm that had been retrieved by the modified Hotchkiss technique.These ten couples underwent 26 ICSI cycles: nine clinical pregnancies were achieved in six couples, including eight after fresh embryo transfer and one after thawed embryo transfer, resulting in seven live births. The average live birth rate per transfer was 28 %.ConclusionsWe report the largest series of births using frozen-thawed spermatozoa retrieved from post-ejaculatory urine by a modified Hotchkiss technique.This series of births demonstrates that this new modified Hotchkiss technique allows for successful association with sperm cryopreservation, leading to an efficient and easy management of couples with refractory retrograde ejaculation.

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Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus: a prospective, controlled study

Cited by 68 publications

References 15 publications

Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus

Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

Successful pregnancies and healthy live births using frozen-thawed sperm retrieved by a new modified Hotchkiss procedure in males with retrograde ejaculation: first case series

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