Ejaculatory dysfunction in men with diabetes mellitus

Abstract

Diabetes mellitus (DM) is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency, in the background of β-cell dysfunction, insulin resistance, or both. Such chronic hyperglycemia is linked to long-term damage to blood vessels, nerves, and various organs. Currently, the worldwide burden of DM and its complications is in increase. Male sexual dysfunction is one of the famous complications of DM, including abnormal orgasmic/ejaculatory functions, desire/libido, and erection. Ejaculatory dysfunction encompasses several disorders related to DM and its complications, such as premature ejaculation, anejaculation (AE), delayed ejaculation, retrograde ejaculation (RE), ejaculatory pain, anesthetic ejaculation, decreased ejaculate volume, and decreased force of ejaculation. The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients. However, although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction, this awareness still lags behind that of other diabetes complications. Therefore, all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men. Besides, introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case. This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.

Understanding and treating ejaculatory dysfunction in men with diabetes mellitus

“…This Diabetes mellitus (DM) is a growing metabolic and endocrinological disorder characterised by chronic hyperglycaemia secondary to absolute/relative insulin insufficiency and/or insulin resistance on a background β-cell dysfunction at the pancreatic islets. 1 It has a rapidly rising prevalence in both, developed and developing countries, with more than 422 million people thought to be suffering from the disease globally in 2014. 2 This has almost quadrupled from 108 million in 1980 worldwide.…”

“…Nevertheless, DM is a known aetiological factor contributing to EjD. 1,9 Whilst disorders of ejaculation are commonly considered concurrently alongside other aspects of sexual dysfunction (largely ED), in this review, we will focus on the ejaculatory aspect of sexual dysfunction, in particular PE, RE, DE and AE as these are the most common ejaculatory disorders associated with DM. There are multiple pathological mechanisms proposed that can contribute to the aetiology of EjD in DM and a knowledge of these can aid the clinician in understanding the various therapies available for diabetic men with ejaculatory disorders.…”

Assessment of the intracavernosal injection platelet‐rich plasma in addition to daily oral tadalafil intake in diabetic patients with erectile dysfunction non‐responding to on‐demand oral PDE5 inhibitors

“…Erectile dysfunction (ED) is a disorder that is usually linked to either psychological or organic causes (cardiovascular, neurological and/or endocrine disorders). It was demonstrated that ED is in diabetics has a prevalence odd of about 3.5 times more than in healthy subjects (Kouidrat et al, 2017; Mostafa & Abdel‐Hamid, 2021; Nutalapati et al, 2020). The occurrence of ED in diabetics has been associated with risk factors like advanced age, longer duration, poor glycaemic control, presence of hypertension, dyslipidaemia, smoking, as well as sedentary lifestyle (Bahar et al, 2020; Tamrakar et al, 2021).…”

Sperm Retrieval in Non-azoospermic Patients with Persistent Ejaculation Dysfunction

“…However, even a candidate for assisted reproductive technique (ART), with normal spermatogenesis and no obstruction, can impose a serious challenge for infertility centers; in other words, ejaculation disorder and obtaining the sperm make sperm retrieval a dilemma for the clinicians ( 6 ). There are also important controversies in certain groups about the best method of sperm retrieval ( 7 ). Therefore, in this article, the methods of obtaining sperm in patients with permanent ejaculation disorders are assessed and the appropriate strategy for treatment is commented and explained.…”