Abstract Introduction Marital consummation represents a cornerstone of the conjugal relationship, where sexual relations within marriage are regarded as a moral and legal duty incumbent upon both spouses. In cases where one partner fails to fulfill this duty, some laws allow the other partner to request and obtain a divorce on the grounds of the harm suffered. Within this framework, forensic evaluation of erectile dysfunction (ED) holds particular significance, as it can determine the fate of the marital relationship. Such assessments must therefore adhere to a strict medicolegal methodology. Objective This work analyzes a forensic evaluation conducted in the context of a divorce case for a non-consummated marriage due to erectile dysfunction, to highlight the specific features and challenges of such a forensic evaluation. Methods This is a case study collected between 2014 and 2024. During this period, six cases of unconsummated marriage secondary to erectile dysfunction were examined, but only one case was selected due to the completeness of the medical and legal documentation. The forensic evaluation was requested by a civil judge in the context of a divorce procedure for non-consummation. The sexual health expert was mandated to determine whether one or both spouses suffered from a sexual disorder preventing intercourse, and to specify the underlying cause. Results The forensic assessment concluded that the husband had erectile dysfunction predating the marriage. The expert based this conclusion on several findings: a mild hypotestosteronemia (though the lab tests showed normal testosterone levels), a visual stimulation test-considered unreliable and not recommended by the scientific societies-and the results of intracavernous injection of vasoactive agents and penile Doppler ultrasonography. However, the latter two tests were deemed insufficient to confirm the organic origin of erectile dysfunction with certainty. Conclusions Forensic assessment of erectile dysfunction represents a major challenge for medical experts due to the multiplicity and interplay of potential etiologies, as well as the limited reliability and potential risks of available paraclinical tests. In all cases, experts should rely primarily on simple, reliable, and reproducible evaluations. To date, no complementary test can definitively confirm the presence or etiology of erectile dysfunction with absolute certainty. Disclosure No
Kaabia et al. (Mon,) studied this question.
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