Retrospective Study of 115 Patients with Diabetes Mellitus Complicated by Retrograde Ejaculation

Objective To analyze relationships between age, fertility history, sexual pleasure, disease duration, HbA1c, and erectile hardness in diabetic patients with retrograde ejaculation (RE). Methods A retrospective analysis was conducted on 115 patients with DM and RE who visited Baoding First Central Hospital from January 2020 to June 2025. Data including age, fertility history, sexual pleasure, DM duration, HbA1c, and Erection Hardness Score (EHS) were collected. Patients were divided into type 1 DM group (n = 28) and type 2 DM group (n = 87). Results Among RE patients, 60.87% reported sexual pleasure; 80% had ED. Type 1 DM patients showed higher rates of anorgasmia (64.29% vs 31.03%, P = 0.004) and childlessness (46.43% vs 13.79%, P < 0.01). Type 1 patients were younger (34.11 ± 7.79 vs 41.74 ± 7.65 years, P < 0.01) with longer disease duration (P < 0.01). EHS was significantly lower in patients without sexual pleasure (P < 0.01). Infertile patients were younger (P < 0.01) and had lower EHS (P = 0.035). Lower EHS correlated strongly with anorgasmia (AUC = 0.831). Conclusion Sexual pleasure, fertility, and EHS in diabetic RE patients correlate with disease duration, DM type, and age. Type 1 DM patients present earlier, with higher risks of ED, anorgasmia, and childlessness. Project Support Baoding Science and Technology Bureau Project (No. 2442ZF206); Baoding Key Laboratory of Prostate and Andrological Disease Prevention and Treatment (No. 2363P007)