Retrospective study of 115 patients with diabetes mellitus complicated by retrograde ejaculation

Retrograde ejaculation is a significant complication of diabetes mellitus, yet its association with other sexual dysfunctions remains under-characterized. Current literature often treats it as an isolated fertility issue, overlooking potential co-morbidities. This study aimed to comprehensively profile the clinical characteristics of diabetic men with retrograde ejaculation and investigate the independent risk factors for severe sexual dysfunction, specifically moderate-to-severe erectile dysfunction. A retrospective analysis of 115 diabetic patients (mean age 39.9 years) confirmed retrograde ejaculation revealed a high prevalence of “triple dysfunction”: 80.0% had complete retrograde ejaculation, 54.8% suffered from moderate-to-severe erectile dysfunction, and 39.1% reported anorgasmia. Type 1 diabetic patients, despite being younger and having higher testosterone levels than Type 2 patients, exhibited worse functional outcomes, including a significantly higher rate of anorgasmia (65.5% vs. 30.2%). Multivariate logistic regression identified diabetes duration (OR 1.70, P < 0.001), age (OR 1.23, P < 0.001), and glycated hemoglobin (OR 1.70, P = 0.004) as independent predictors of moderate-to-severe erectile dysfunction. Lifestyle factors such as smoking and alcohol consumption were not significant independent predictors in the adjusted model. Retrograde ejaculation in diabetic men is rarely an isolated symptom but part of a complex syndrome frequently co-existing with severe erectile dysfunction and anorgasmia. The severity of this dysfunction is primarily driven by the chronicity of diabetes and long-term glycemic instability rather than age or lifestyle factors alone. Clinicians should adopt a holistic approach, screening for co-morbid sexual and psychological dysfunctions to guide precise management.