Medico-legal evaluation of patients with genital disorders in Upper Egypt: a preliminary data.
Abdelhamed, A1; Abu El-Hamd, M1
1: Sohag University, Egypt
Objectives: In Upper Egypt, the Forensic Medicine Authority of the Ministry of Justice transfers patients with genital disorders for proper Andrological evaluation, which helps in making its decisions according to the Law. Therefore, our study aims to evaluate the types of cases referred for andrological evaluation, their clinical, laboratory, imaging characteristics and finally the decisions of these cases.
Material and Methods: The study included 15 patients with genital disorders who referred from the forensic medicine authority for evaluation. Initial evaluation was done through history taking, general & genital examination. Hormonal profile including total Testosterone, FSH, LH, Prolactin, Estradiol (E2), and random blood sugar were done. Karyotyping, scrotal and/or penile color Doppler were done when appropriate
Results: Data was presented as median (range), or percentage (%) when appropriate. Patients' characteristics showed age 29.5 (1-46) years. Most patients were married 73.3% (11/15). Cause of referral was mainly for erectile function evaluation due to marital conflicts 60%. (9/15). Other causes included sex determination 20% and genital assault 20%. All cases were free from medical co-morbidity (Diabetes, Hypertension) except one patient was with Dyslipidemia. General examination was normal in most patients 80% (12/15). Abnormal genital examination was noted in the form of hypospadias 13.3% (2/15), atrophic testis 26.6% (4/15), and varicocele 40% (6/15). Patients hormonal profile showed total testosterone 4.6 (3.69-7.82) ng/ml, FSH 3.53 (0.6-59.4) mIU/ml, LH 4.6(1.2-23.8) mIU/ml, prolactin 12.55 (4.9-18) ng/ml, and E2 43 (24-56.9) pg/ml. As regards the erectile function evaluation, patients with normal evaluation, venogenic, arteriogenic erectile dysfunction 26.7% (4/15), 26.7% (4/15), 6.6% (1/15) respectively. Other patients' diagnosis included normal genitalia, atrophic testis, and male pseudo hermaphrodite.
Conclusions: There is a great diversity in genital disorders patients referred for medico legal evaluation in Upper Egypt. A more meticulous well designed approach is needed for proper evaluation of those patients as serious legal consequences result from this evaluation.
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