Compensatory Impotence

Heo, Jeong Moon; Park, Nam Cheol

Abstract

Recently, compensatory impotence has increased with the development of industry, the rise in vehicles, the sexual revolution, the secured legal and insurance services. Compensatory impotence is a medicolegal term for the male erectile dysfunction that requires a doctor's medical certificate and opinion are regarding legal responsibility, reparation or compensation rather than primary medical care of the diagnosis and treatment by the patient or his procurator. We studied 69 cases of compensatory impotence (mean age 38.1, range 24-58) at the Department of Urology, Pusan National University Hospital from January 1987 to December 1995. The marital status were married, separated, single and divorced in 37 (53.6%),14 (20.3%), 13 (18.8%) and 5 (7.3%) cases, respectively. Opinions as to cause of impotence were sought from medical documents of university hospital 34 (49.3%), legal documents required from the court 25 (36.2%) and industrial accident insurance documents 10 (14.5%). Trauma constituted 47 cases (68.1%) while 22 (31.9%) had no history of trauma. With trauma, spinal cord injury was the most common cause of impotence in 18 cases (38.3%), followed by urethral injury in 14 (29.8%), and penoscrotal injury, head trauma, pelvic bone fracture, electrical bum and bladder rupture in 5 (10.6%), 4 (8.5%), 3 (6.4%), 2 (4.3%), and 1 (2.1%), respectively. Organic impotence is predominant cause in trauma group and psychogenic is highest in nontrauma group. Of 34 cases who the impotence therapy was recommended, 14 (41.2%) were accepted. In conclusion, for the evaluation and management of the compensatory impotence with complex issue of legal, financial and social aspects, physician's objective mental attitude and the accurate medical survey with the legal comprehensions are primarily important. Additionally, common criteria for compensation should be established by the cooperative expertise of experts in the fields of medicine, law and insurance.