Treatments of premature ejaculation and psychogenic impotence: a critical review of the literature.

Research on the treatments of premature ejaculation and psychogenic impotence is reviewed. Problems with the existing definitions of these disorders are discussed. The studies are reviewed under seven major headings: depth therapies, behavior therapies, hypnosis, drug therapy, mechanotherapy, reeducative and supportive therapies, and extensive retraining programs. Most of the studies were case reports. Considerable methodological weaknesses were found, most notably the failure to specify subject and treatment variables, the confounding of treatment methods, inadequate or nonexistent control groups, limited, if any, follow-up assessments of treatment effects, and a failure to obtain partner validation of subjects' progress. The studies which used systematic desensitization and the studies which assessed the extensive retraining programs reported the most consistently positive results, although better-controlled replications are needed. Among other issues, it was suggested that future investigators examine the impact of treatment of homogeneous samples and conduct controlled comparisons of different treatment methods.