Medical treatment of retrograde ejaculation in diabetic patients: a hope for spontaneous pregnancy

J Sex Med. 2008 Jan;5(1):194-8. doi: 10.1111/j.1743-6109.2007.00456.x. Epub 2007 Apr 13.


Introduction: Retrograde ejaculation (RE) is one of the complications of diabetes mellitus. Different therapeutic approaches are present, whether medical or surgical, with limited success rates.

Aim: The aim of the present study is to evaluate different drug regimens for the medical treatment of RE in diabetic patients.

Patients and methods: Thirty-three diabetic patients with RE (23 complete and 10 partial) were included in the study. Patients were given three sequential courses of medical treatment: imipramine 25 mg twice/day, pseudoephidrine 120 mg twice/day, or combination of the two drugs.

Main outcome measures: Establishment of antegrade ejaculate in cases with complete RE and improvement of semen quality in case of partial RE.

Results: In cases with complete RE, imipramine was successful in producing antegrade ejaculate in 10 patients (38.5%), while pseudoephedrine was successful in 11 patients (47.8%), and both drugs given together was successful in 16 patients (61.5%). In cases with partial RE, there was significant increase in the antegrade semen sample as regards semen volume, sperm count, total, and progressive motility with imipramine alone, pseudoephidrine alone, and both drugs.

Conclusion: From the present study we can conclude that medical treatment for RE in diabetic patients is a promising method and should be the first line of treatment in these cases.

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / administration & dosage
  • Diabetes Mellitus, Type 2 / complications*
  • Ejaculation / drug effects
  • Erectile Dysfunction / complications
  • Erectile Dysfunction / drug therapy*
  • Erectile Dysfunction / etiology*
  • Female
  • Humans
  • Infertility, Male / drug therapy*
  • Infertility, Male / etiology
  • Male
  • Middle Aged
  • Treatment Outcome


  • Antidepressive Agents, Tricyclic