Abstract：
Diabetes mellitus is a rapidly rising metabolic disorder with important systemic complications. Global figures have demonstrated the prevalence of diabetes mellitus has almost quadrupled from 108 million in 1980 to 422 million in 2014, with a current prevalence of over 525 million. Of the male sexual dysfunction resulting from diabetes mellitus, significant focus is afforded to erectile dysfunction. Nevertheless, ejaculatory dysfunction constitutes important sexual sequelae in diabetic men, with up to 35%-50% of men with diabetes mellitus suffering from ejaculatory dysfunction. Despite this, aspects of its pathophysiology and treatment are less well understood than erectile dysfunction. The main disorders of ejaculation include premature ejaculation, delayed ejaculation, anejaculation and retrograde ejaculation. Although ejaculatory dysfunction in diabetes mellitus can have complex multifactorial aetiology, understanding its pathophysiological mechanisms has facilitated the development of therapies in the management of ejaculatory dysfunction. Most of our understanding of its pathophysiology is derived from diabetic animal models; however, observational studies in humans have also provided useful information in elucidating important associative factors potentially contributing to ejaculatory dysfunction in diabetic men. These have provided the potential for more tailored treatment regimens in patients depending on the ejaculatory disorder, other co-existing sequelae of diabetes mellitus, specific metabolic factors as well as the need for fertility treatment. However, evidence for treatment of ejaculatory dysfunction, especially delayed ejaculation and retrograde ejaculation, is based on low-level evidence comprising small sample-size series and retrospective or cross-sectional studies. Whilst promising findings from large randomised controlled trials have provided strong evidence for the licensed treatment of premature ejaculation, similar robust studies are needed to accurately elucidate factors predicting ejaculatory dysfunction in diabetes mellitus, as well as for the development of pharmacotherapies for delayed ejaculation and retrograde ejaculation. Similarly, more contemporary robust data are required for fertility outcomes in these patients, including methods of sperm retrieval and assisted reproductive techniques in retrograde ejaculation.
摘要：
糖尿病是一种快速上升的代谢紊乱性疾病，具有重要的全身性并发症。全球数据表明，糖尿病的患病率几乎翻了两番，从1980年的1.08亿增加到2014年的4.22亿，目前的患病率超过5.25亿。在糖尿病导致的男性性功能障碍中，显著的焦点是提供勃起功能障碍。然而，射精功能障碍构成糖尿病男性重要的性后遗症，高达35％-50％的糖尿病男性患有射精功能障碍。尽管如此,其病理生理学和治疗方面不如勃起功能障碍。射精的主要障碍包括早泄，延迟射精,射精和逆行射精。尽管糖尿病的射精功能障碍可能具有复杂的多因素病因，了解其病理生理机制有助于治疗射精功能障碍的发展.我们对其病理生理学的大多数理解都来自糖尿病动物模型；然而，人体观察性研究也为阐明糖尿病男性射精功能障碍的重要关联因素提供了有用的信息.这些为根据射精障碍患者提供了更量身定制的治疗方案的潜力，其他共存的糖尿病后遗症，特定的代谢因素以及生育治疗的需要。然而,射精功能障碍治疗的证据，尤其是延迟射精和逆行射精,基于低水平的证据，包括小样本量系列和回顾性或横断面研究。虽然来自大型随机对照试验的有希望的发现为获得许可的早泄治疗提供了强有力的证据，需要类似的有力研究来准确阐明预测糖尿病射精功能障碍的因素，以及开发延迟射精和逆行射精的药物疗法。同样，这些患者的生育结果需要更多当代可靠的数据，包括逆行射精的精子提取方法和辅助生殖技术。
