ABSTRACT
Two cases of coexisting coital premature ejaculation and masturbatory ejaculatory incompetence are presented. Prescribed penile self-manipulation exercises failed to produce sensations premonitory to ejaculation. For one subject, this was also true for partner manipulation. The other subject received partner manipulation concurrent with stimulating body contact, but not as an isolated exercise. Both men experienced high levels of arousal and ejaculated during non-manipulative extravaginal partner stimulation. Combined penile stimulation therapy and marital therapy eventually led to improved ejaculatory control. Some of the previously proposed causative mechanisms for premature ejaculation are briefly reviewed and some implications of our observations for these proposed mechanisms are discussed. A modification of penile stimulation therapy for premature ejaculation when associated with masturbatory ejaculatory incompetence is suggested.