title: Efficacy of treatment with pseudoephedrine in men with retrograde ejaculation.
abstract: The use of pseudoephedrine, an alpha agonist, for the treatment of retrograde ejaculation is well-known, however, there is no clear consensus from the literature regarding its efficacy and treatment protocol. We evaluated the efficacy of pseudoephedrine treatment in patients with retrograde ejaculation, utilizing a yet undescribed short-period treatment protocol. Twenty men were medically treated with pseudoephedrine for retrograde ejaculation between January 2010 and May 2016 (12 with complete retrograde ejaculation and 8 with partial retrograde ejaculation). All patients had a semen analysis and post-ejaculatory urinalysis before and after treatment. The treatment protocol consisted of 60 mg of pseudoephedrine every 6 h on the day before semen analysis and two more 60 mg doses on the day of the semen analysis. Diabetes was the most common etiology for complete retrograde ejaculation (60%), whereas an idiopathic cause was the most common etiology for partial retrograde ejaculation (82%). Of the 12 complete retrograde ejaculation patients treated with pseudoephedrine prior to semen analysis, 7 (58.3%) recovered spermatozoa in the antegrade ejaculate, with a mean total sperm count of 273.5 ± 172.5 million. Of the eight patients with partial retrograde ejaculation, five (62.5%) had a ≥50% increase in the antegrade total sperm count. In this group, the mean total sperm count increased from 26.9 ± 8.5 million before treatment to 84.2 ± 24.6 million after treatment, whereas the percentage of spermatozoa in the urine declined from 43.2 ± 9% to 17 ± 10%, respectively (both p < 0.05). Overall, in men with retrograde ejaculation treated with a pseudoephedrine regimen prior to ejaculation, some improvement in seminal parameters occurred in 14 (70%) patients, with 10 patients (38.5% of all patients) achieving antegrade total sperm counts over 39 million.
authors.affiliation: Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: O
authors.identifier: 0000-0002-4211-6277
authors.initials: O
authors.lastname: Shoshany
authors.affiliation: Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: N
authors.initials: N
authors.lastname: Abhyankar
authors.affiliation: State University of New York Upstate Medical University, Syracuse, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Elyaguov
authors.affiliation: Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: C
authors.initials: C
authors.lastname: Niederberger
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D016208:Databases, Factual; D004334:Drug Administration Schedule; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D054199:Pseudoephedrine / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000316:Adrenergic alpha-Agonists; D054199:Pseudoephedrine
keywords: male infertility; post-ejaculatory urinalysis; pseudoephedrine; retrograde ejaculation