The aim of the study was to evaluate the efficiency, after 1 year, of combined use of psychodynamic psychotherapy integrating virtual reality (VR) for the treatment of erectile dysfunction (ED) and premature ejaculation (PE) in 160 heterosexual males who had neither any prior sexual therapy nor had made use (either before, during or after therapy) of any specific pharmaceuticals for the treatment of primary sexual dysfunction. All subjects had given their informed consent. After a clinical diagnosis in an andrologic center, 50 presumably psychological ED (average age 43.7 years), 60 mixed ED (53.9 years) and 50 primary PE (39 years) who suffered these problems over 6 months were undergoing a cycle of 12 sessions, over a 25-week period, of psychotherapy, integrating an audio CD and helmet with miniature television screens that projected specially designed CD-ROM program on the ontogenetic development of male sexual identity. The clinical follow up was done after 6 and 12 months after the cycle. After one year, the overall partial (two times out of three) and complete positive response rate for psychological ED was 75%, for mixed ED was 47% and for PE was 54%. We considered drop-out cases as only before the 7th session of the treatment cycle, the drop-outs after session 7 and the patients that did not show up for follow-up are counted as negative results. Two patients reported nausea and one, vertigo during the first 15-min virtual reality experience. Considering the particular way that full-immersion virtual reality involves the subject who experiences it, we hypothesized that this methodological approach could speed up the therapeutic process. The evidence that positive results persist over time allows us to hypothesize that certain changes in cerebral function can be possible and that these changes are correlated to favorable sexual performance in the male.
The present study is based on the observation that computer-simulated reality applied by virtual reality (VR) methods may offer a new means of treating male erectile disorders. The experimental design was based on the theory of psychological development, supported by multimedia acoustic experience and clinical tests. The method involved the use of virtual reality equipment and specially designed CD-ROM programmes. Excluding 15% drop-outs, the success rate was 82% for male erectile disorders due to psychological factors and 84%, excluding 17% drop-outs, for combined factor disorders. Psychotherapy with VR seems to hasten the healing process and reduce drop-outs, suggesting that this method opens or consolidates new or rarely used brain pathways, facilitating the¯ow of new mnemonic associations that promote the satisfaction of natural drives.
Virtual environments have recently attracted much attention in clinical medicine. Given the new opportunities offered by this technology, some on-going research projects are now testing the possibility of using virtual reality (VR) for behavioral therapy, especially in the treatment of phobias. This paper describes a psychodynamic psychotherapy, integrating VR, used for the treatment of erection dysfunctions and premature ejaculation. The rationale of this approach is presented together with the results obtained on two different clinical samples: patients who had been impotent for at least 6 months (N = 50), and patients affected by primary premature ejaculation (n = 16).
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