Determination of potency

FMT- Study materials

1. EXAMINATION OF MALE (POTENCY CERTIFICATE) DR. SATISH KUMAR HEAD OF DEPARTMENT FORENSIC MEDICINE

2. Sexual Act In male the sexual act comprises of erection, intermission and ejaculation. Female is also an active party to intercourse. Impotence – is inability of a person to perform sexual intercourse. Better term for impotence is Erectile disfunction

3. Common situation wherein such examination is conducted. Criminal cases – Rape, Adultery, unnatural sexual offences. Civil cases Nullity of marriage ( U nconsummated Marriage Disputed paternity Claims/ Damages arising from injuries resulted in impotence

4. Guidelines for such examination Examination may be undertaken on the authorization of competent authority Magistrate or police officer. If person is arrested, examination without consent can be done.

5. Medical history Habits - 1. Smoking, 2. Alcohol, 3. Drugs Diabetes - when complicated by peripheral neuropathy Trauma - Head injury, Amputation of penis, spinal injury -(1 st Lumber vertebra spinal nerve concerned with erection and ejaculation).

6. Venereal disease - syphilis in tertiary stage can affect the posterior column of spinal cord can cause impotence. Hypertension - Ganglion blocking drugs can cause impotence. Occupation - Painters or other workers exposé to lead - neuropathy.

7. History of sexual development Masturbation Night emission & morning erection of penis. Homo sexual practice. H/O sexual intercourse. Libido. Sexual development. Marital status (No. of children) Sexual deviation.

8. History related to local diseases . Congenital absence of penis, infantile penis. Amputation of penis at the root by trauma or surgical removal. Large hydrocele. History suggestion of Endocrine disorder like Hypopituitarism CNS disorders like syringomelia.

9. Other causes are Tumors of spinal cord. Spina bifida. Pelvic fractures. Tranquilizers. Surgery of pelvic organs.

10. Examination 1.Physical examination Height Weight Build – good/ moderate/ poor Adam's apple Hair - public/ Axillary/ Facial/ Chest scalp (male type hairline)

11. 2.Local Examination Penis Penis – present/ absent Development – Adult size or infantile. Length & circumference in flaccid state Anomalies developmental/ acquired. Evidence of disease F oreskin – retractable/ non retractable Glans penis sensation – present/ Absent Injuries.

12. Scrotum Scrotum – pendulous or non pendulous Testis - Present/ Absent – Rt. & Lt. Epididymis & cord Evidence of – STD Urethral discharge – Present/ Absent Ulcers/ any other lesion. Psychological evaluation for Impotence - Anxieties - Fears - Depression - phobias - Repulsion against partner ( quoadhoc )

13. Systemic examination CVS CNS GIT RS Abdomen & Spine Investigations Blood for sugar and VDRL Xray head, spine, pelvis- if trauma LFT – To diagnose liner failure

14. Opinion: Every healthy individual is presumed to be potent but certificate to that effect should not be given as psychogenic impotence can not be ruled out by physical examination. Hence certificate is usually given in double negative form. “There is nothing to suggest that the above person is incapable of performing the sexual act”. The above subject is incapable of performing the sexual act because of the following impediments.