Comprehensive Review and Recommendations for Evaluation of Sexual Potency of Male in Context of Current Indian legal system

Authors

  • S P Akhade Assistant Professor, Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences (AIIMS), Raipur.
  • P Kothari Additional Professor,Department of Urology. Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai.
  • P R Sabale Professor, Department of Forensic Medicine & Toxicology. Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai.
  • K H Chavali Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences (AIIMS), Raipur.

DOI:

https://doi.org/10.48165/

Keywords:

Impotence, Potency test, Indian legal system, Medicolegal examination

Abstract

To discuss the current practice, standard procedures and recommendations for evaluation of male impotence/sexual dysfunction in context  of the Indian legal system. Evaluation of a man for potency is done for various reasons like accusation of rape, non-consummation of  marriage in a plea for annulment or compensation claims arising out of damage to sexual function secondary to accidents or any other  means. Such evaluation is done after requisition by investigating officers in criminal cases or by the person himself in civil cases to verify  or rule out allegations of impotence. It is a common practice for Indian police to request a potency examination in almost every case of  sexual assault, despite the fact that the examination has very little impact on the outcome of the case in court. In the Indian scenario, even  after a complete evaluation for impotence, medicolegal opinion is framed in a nebulous double negative format rather than a precise  scientific manner. The Indian courts would welcome such examination in relevant case and desire that the experts frame objective and  unequivocal opinions. Various articles, books, court judgments were reviewed to determine the current practice followed in determination  of sexual potency in males. Asystematic effort is made to make the examination completely justifiable with a more objective and scientific  opinion.  

References

Avasthi A, Grover S, Sathyanarayana Rao TS. Clinical Practice Guidelines for Management of Sexual Dysfunction. Indian J Psychiatry. 2017;59(Suppl 1):S91-s115.

Burnett Al. The Science and Practice of Erection Physiology: Story of A Revolutionary Gaseous Molecule. Trans Am Clin Climatol Assoc. 2019;130:51-9.

Rajfer J, Aronson WJ, Bush PA, Dorey FJ, Ignarro LJ. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med. 1992;326(2):90-4.

Ghalayini IF. Nitric oxide-cyclic GMP pathway with some emphasis on cavernosal contractility. Int J Impot Res. 2004;16(6):459-69.

Panchatsharam PK, Durland J, Zito PM. Physiology, Erection. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–PMID: 30020650

Raheel MS, Yadav A, Pooniya S, Gupta SK, Jaiswal AK. Potency test of a rape accused in India – Rationale, problems and suggestions in light of the Criminal Law (Amendment) Act, 2013. Egyptian Journal of Forensic Sciences.

;6(4):333-6.

Aggarwal A. Impotence and Sterility. Textbook of forensic medicine and toxicology. New Delhi: Avichal Publishing Company; 2014. p. 418-22.

K.S. Narayan Reddy OPM. Impotence and Sterility. The essentials of forensic medicine and toxicology. New Delhi: Jaypee Brothers Medical Publishers(P) limited; 2017.

CrPc Section 53, (25 January 1974, 1973).

Meeting Rapots LAEDC. Assessment of the patient with erectile dysfunction. International Journal of Impotence Research. 2003:Suppl 7 S9-S11.

Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92(1):1-6.

Andersson KE. Erectile physiological and pathphysiological pathways involved in erectile dysfunction. J Urol. 2003;170 (2 Pt 2):S6-13; discussion S-4.

Salvio G, Martino M, Giancola G, Arnaldi G, Balercia G. Hypothalamic-Pituitary Diseases and Erectile Dysfunction. J Clin Med. 2021;10(12).

Phé V, Rouprêt M. Erectile dysfunction and diabetes: a review of the current evidence-based medicine and a synthesis of the main available therapies. Diabetes Metab. 2012;38(1):1-13.

Singh S. Comparison and critical analysis of the rape laws before and after the Criminal Law Amendment (2013). Academike articles on legal issues 2015.

Kumar L. Recent advances in Forensic Medicine & Toxicology. In: Biswas G, editor. An approach to examination of a case of erectile dysfunction. 2. New Delhi: Jaypee Brothers Medical Publishers; 2018. p. 177-94.

The Criminal Law (Amendment) Act, 2013 (3/02/2013, 2013).

Domkundwar S, Jadhav VV, Khandelwal S. Rationale of evaluation of potency in medicolegal cases of sexual

assault by penile color doppler with Injection of Papaverine2020.

Vij K. Impotence, Sterility, Sterilisation and Artificial Insemination. Vij K, editor. New Delhi: Elsevier India Pvt Ltd; 2014. 395 p.

BHAT V. State vs Jai Bhagwan Pandla. Delhi District Court; 2014.

The Protection Of Children From Sexual Offences Act, 2012, Stat. Act No. 32 Of 2012 (19 June 2012, 2012).

Section 320 Indian Penal code, (06/10/1860, 1860).

Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32(4):379-95.

Hatzimouratidis K, Hatzichristou D. How to treat erectile dysfunction in men with diabetes: from pathophysiology to treatment. Curr Diab Rep. 2014;14(11):545.

McMahon CG. Current diagnosis and management of erectile dysfunction. Med J Aust. 2019;210(10):469-76.

Savoy M, O'Gurek D, Brown-James A. Sexual health history: Techniques and tips. Am Fam Physician. 2020;101(5):286-93.

Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003.

Shamloul R, Ghanem H. Erectile dysfunction. Lancet. 2013;381(9861):153-65.

Malavige LS, Levy JC. Erectile dysfunction in diabetes mellitus. J Sex Med. 2009;6(5):1232-47.

Vivekanandan KS, Thangadurai P, Prasad J, Jacob KS. Sexual Dysfunction among men in rural Tamil Nadu: Nature, Prevalence, Clinical Features, and Explanatory Models. Indian J Psychol Med. 2019;41(1):81-6.

Carvalho J, Vieira AL, Nobre P. Latent structures of male sexual functioning. J Sex Med. 2011;8(9):2501-11.

Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J Sex Med. 2016;13(4):538-71.

Boddi V, Corona G, Monami M, Fisher AD, Bandini E, Melani C, et al. Priapus is happier with Venus than with Bacchus. J Sex Med. 2010;7(8):2831-41.

Rosen RC. Psychogenic erectile dysfunction. Classification and management. Urol Clin North Am. 2001;28(2):269-78.

Bodie JA, Beeman WW, Monga M. Psychogenic erectile dysfunction. Int J Psychiatry Med. 2003;33(3):273-93.

O. P. Saini SA, Buri S, Saini P.K., Mathur P.N.,Gahlot R. K. . Paraphimosis – A case report and medicolegal importance Journal of Indian Academy of Forensic Medicine. 2008;30(2):82-3.

Condorelli R, Calogero AE, La Vignera S. Relationship

between Testicular Volume and Conventional or Nonconventional Sperm Parameters. International Journal of Endocrinology. 2013;2013:145792.

Rajkumar RP, Kumaran AK. Depression and anxiety in men with sexual dysfunction: a retrospective study. Compr Psychiatry. 2015;60:114-8.

Boddi V, Fanni E, Castellini G, Fisher AD, Corona G, Maggi M. Conflicts within the family and within the couple as contextual factors in the determinism of male Sexual Dysfunction. J Sex Med. 2015;12(12):2425-35.

Nichols DJ, Muirhead GJ, Harness JA. Pharmacokinetics of sildenafil after single oral doses in healthy male subjects: absolute bioavailability, food effects and dose proportionality. British Journal of Clinical Pharmacology. 2002;53(s1):5S-12S.

Al-Adl AM, Abdel-Wahab O, El-Karamany T, Aal AA. Combined intracavernous vasoactive drugs and sildenafil citrate in treatment of severe erectile dysfunction not responding to on-demand monotherapy. Arab J Urol. 2011;9(2):153-8.

Shamloul R, El-Dakhly M, Ghanem H, Gadallah A, Mokhtar H. Intracavernous chlorpromazine versus phentolamine: a double-blind clinical comparative study. J Sex Med. 2004;1(3):310-3.

Coombs PG, Heck M, Guhring P, Narus J, Mulhall JP. A review of outcomes of an intracavernosal injection therapy programme. BJU Int. 2012;110(11):1787-91.

Park JK, Park JS, Jeon SB, Cui WS, Kim SZ, Kang KK, et al. Why a combined intracavernosal injection with trimix and oral sildenafil is reliable therapy in the ultrasonographic evaluation of erectile dysfunction. BJU International.

;102(8):993-7.

Shabsigh R. Hypogonadism and erectile dysfunction: the role for testosterone therapy. Int J Impot Res. 2003;15 Suppl 4:S9- 13.

Ravikanth R. Diagnostic categorization of erectile dysfunction using duplex color doppler ultrasonography and significance of phentolamine redosing in abolishing false diagnosis of venous leak impotence: A single center experience. Indian J Radiol Imaging. 2020;30(3):344-53.

Melmed S PK, Larsen PR. Philadelphia, PA: Elsevier; 2011.

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536-59.

Mulhall JP, Valenzuela R, Aviv N, Parker M. Effect of testosterone supplementation on sexual function in hypogonadal men with erectile dysfunction. Urology. 2004;63(2):348-52; discussion 52-3.

Shabsigh R. Testosterone therapy in erectile dysfunction and hypogonadism. J Sex Med. 2005;2(6):785-92.

Greenstein A, Mabjeesh NJ, Sofer M, Kaver I, Matzkin H, Chen J. Does sildenafil combined with testosterone gel improve erectile dysfunction in hypogonadal men in whom testosterone supplement therapy alone failed? J Urol. 2005;173(2):530-2.

Sartorius G, Spasevska S, Idan A, Turner L, Forbes E, Zamojska A, et al. Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: the healthy man study. Clin Endocrinol (Oxf). 2012;77(5):755-63.

Patel U, Amin Z, Friedman E, Vale J, Kirby RW, Lees WR. Colour flow and spectral Doppler imaging after papaverine induced penile erection in 220 impotent men: study of temporal patterns and the importance of repeated sampling, velocity asymmetry and vascular anomalies. Clin Radiol. 1993;48(1):18-24.

Aversa A, Isidori AM, Gianfrilli D, Greco EA, Graziottin A, Zizzo G, et al. Are subjects with erectile dysfunction aware of their condition? Results from a retrospective study based on an Italian free-call information service. J Endocrinol Invest. 2004;27(6):548-56.

Fitzgerald SW, Erickson SJ, Foley WD, Lipchik EO, Lawson TL. Color Doppler sonography in the evaluation of erectile dysfunction: patterns of temporal response to papaverine. AJR Am J Roentgenol. 1991;157(2):331-6.

Gao QQ, Chen JH, Chen Y, Song T, Dai YT. Dynamic infusion cavernosometry and cavernosography for classifying venous erectile dysfunction and its significance for individual treatment. Chin Med J (Engl). 2019;132(4):405-10.

Karacan I, Williams RL, Thornby JI, Salis PJ. Sleep-related penile tumescence as a function of age. Am J Psychiatry. 1975;132(9):932-7.

Burnett AL. Nitric oxide in the penis: physiology and pathology. J Urol. 1997;157(1):320-4.

Wang ZY, Song LJ. [Application of nocturnal penile tumescence test in the diagnosis of erectile dysfunction]. Zhonghua Nan Ke Xue. 2019;25(5):356-9.

Zou Z, Lin H, Zhang Y, Wang R. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev. 2019;7(3):442-54.

Matthews BJ, Crutchfield MB. Painful nocturnal penile erections associated with rapid eye movement sleep. Sleep. 1987;10(2):184-7.

Zou ZJ, Chen ST, Ma GC, Lai YF, Yang XJ, Feng JR, et al. Consecutive nightly measurements are needed for accurate evaluation of nocturnal erectile capacity when the first-night laboratory recording is abnormal. Asian J Androl.

;22(1):94-9.

Greenstein A, Mabjeesh NJ, Sofer M, Kaver I, Matzkin H, Chen J. Are consecutive nightly recordings required for valid evaluation of sleep-associated erections? Int J Impot Res. 2007;19(2):196-9.

Jannini EA, Granata AM, Hatzimouratidis K, Goldstein I. Use and abuse of Rigiscan in the diagnosis of erectile dysfunction. J Sex Med. 2009;6(7):1820-9.

Downloads

Published

2023-12-05

Issue

Vol. 45 No. 1 (2023): Journal of Indian Academy of Forensic Medicine (Jan-Mar) 2023

Section

Articles

How to Cite

Comprehensive Review and Recommendations for Evaluation of Sexual Potency of Male in Context of Current Indian legal system . (2023). Journal of Indian Academy of Forensic Medicine, 45(1), 95–101. https://doi.org/10.48165/