Hi Guest: In the world of normal sexual functioning certainly what you say is correct. But here in RE land we tend to cut guys like Reston some slack because lack of attraction the partner is a primary cause of situational retarded ejaculation and is quite common in married men with RE.
As has been said here many times, a man's primary sense of arousal is the visual. Men with RE are thought to have a highly sensitive arousal system. If they percieve something is wrong the orgasmic threshold cannot be reached.
Most men don't have this problem. Despite what I said about the visual sense being important, a normally functioning man, given enough time without any kind of sexual relief will find the visual sense overidden by intense desire. This doesn't happen in men with RE.
When attraction is an issue for a married couple, a Sex Therapist will usually work with both of them to come to some kind of comprimise. Many women, lacking a sex life with their husbands because of RE will happily oblige. Some will hold their ground and demand the patient change his attitude. This seldom works. She will have to make some changes if she wants him to function sexually. Perhaps not implants but some kind of change that will heighten his arousal for her.
And by the way this certainly isn't just a problem for men. Any quick scan of women's sexual dysfunction websites will turn up a litany of complaints from women about how their husbands have "let themselves go" And although women value words and intimacy more to get sexually aroused, because generally their orgasmic system is far more sensitive to disruption than a man's, they tend to have more orgasmic problems caused by a number of factors in a relationship including the visual.