He Koro syndrome Is a disorder in which the patient believes that his genitals are shrinking or retracting into the abdomen and will soon disappear.
It is more common in men, who are convinced that their penis is getting smaller and smaller, and even that it could invaginate itself inside their bodies, Causing them to die.
In cases of women with this syndrome, they believe that their nipples are being reduced or that their vulva is about to disappear, although clearly nothing strange or abnormal is happening with their genitals.
Patients with this syndrome are very anxious and often have Obsessive thoughts And compulsive behaviors: try to stretch or enlarge Your penis or your nipples with different elements that could harm them.
Koro's syndrome is also known as genital retraction syndrome and is more common in Asian countries. Cases of hysteria have been documented Massive disease around this syndrome, which could"spill"from one person to another in certain cultures.
Characteristics of the primary Koro and secondary Koro
There are basically two types of Koro syndrome.
The primary Koro, which would have a cultural origin and occur in individuals who do not suffer from other mental disorders, and the secondary Koro, which appears In people suffering from diseases such as schizophrenia, body dysmorphic disorder or anxiety disorders.
Features of Koro primary
It is frequent in countries like India, China and Japan, because its cause is strongly linked to cultural beliefs of that region of the world.
The majority of men in whom this disorder appears are single, with few studies, little sex education and deep beliefs in phenomena Supernatural, like spells and spells.
In these cases, the patient exhibits symptoms of much fear and anxiety. In addition to believing that their genitals are shrinking and that they could soon Disappear, thinks that he could die because of this.
Many patients report that the problem with their genitals began after they had sexual contact with a prostitute, or that it might be related to the Masturbation or nighttime pollution.
This shows the close relationship of this syndrome with cultural beliefs and the lack of adequate sex education.
Features of Koro secundario
The cases of Koro syndrome that occur outside the endemic countries, that is, outside Southeast Asia, are"incomplete"cases of the syndrome, Which is usually caused by another underlying mental disorder.
In cases of secondary Koro, the patient also believes that his genitals are shrinking and may disappear, but he does not think he could die For that and the Anxiety box Associated is not as serious as in the primary Koro.
Signs and symptoms of Koro's syndrome
As you have read in the previous paragraphs, patients with Koro syndrome suffer from anxiety attacks because they are tormented by the idea that their Genitals are shrinking, although it is not possible to see that permanent changes are actually happening in their sexual organs.
That is, the penis or other genital regions could be contracted temporarily by effect of low temperatures for example, but it is an effect Totally reversible, that should not trigger anxiety symptoms in a person, unless the person has Koro's syndrome.
According to the literature reviews referring to cases studied by Koro, the anxiety attacks They usually remit after a few hours, Although they could last up to a couple of days.
In other cases, Koro's symptoms may persist for a longer time and be chronically established, increasing the likelihood that the With other metal diseases, such as Body dysmorphic disorder.
In addition to the supposed retraction of the penis, other symptoms may include altered perception of the shape of the penis, loss of muscle tone in the And paresthesia in the genital area (abnormal or abnormal sensations, tingling, tingling, etc.).
The patient also feels afraid of dying, that his penis disappears totally or of having erectile dysfunctions in the future.
The feeling of near death and genital retraction is typical of the cases of primary Koro, which appear mainly in Southeast Asia.
Other beliefs that the patient may present in Koro's syndrome include the fear of becoming a eunuch , Of becoming a woman, of being Sterile, that their urinary tract obstructs, believe that they are possessed by an evil spirit or that they are victims of a spell.
Patients with extreme anxiety may resort to physical methods to avoid retraction of the penis, anchoring it with different devices Which could cause damage.
In the case of women, it is possible that the breasts or nipples are stretched trying to prevent shrinkage and even some Iron in the nipple, which could also lead to injury.
What causes Koro's syndrome?
As already mentioned, psychosexual conflicts, certain personality factors and cultural beliefs are the main causes of Koro's syndrome.
In patients with this condition who are not found in Southeast Asia, there are often antecedents such as sexual promiscuity, feelings of guilt After masturbation, sexual impotence, etc.
How mass hysteria cases are explained
There have been reports of massive hysteria of Koro's syndrome, that is, sets of people in which symptoms appear, apparently They would have"caught"one another.
For example, a worker from a mill in West Bengal, single and low-income, was treated at the local psychiatric Patient reported that for two or three days his penis was shrinking and getting into his abdomen, a fact that was weakening. I could not sleep By anxiety and thought repetitively in this idea.
He said he did not use any type of drugs and in his medical history no psychiatric antecedents were found. The patient believed that his symptoms were due to Nocturnal pollution and masturbation.
To avoid retraction of his genitals, he immersed himself in a nearby pond, staying there all night, for 14 or 16 hours, which provoked him A respiratory infection.
This fact was known by his co-workers and locals. Two days later, six workers from the same mill said Present similar symptoms and decided to imitate the behavior of his co-worker.
The doctors then decided to stay alert and carry out group therapy for the workers, with which the outbreak remitted after five or six days.
But a few days later another local worker, divorced of 53 years, who had been absent in those days, went to the emergency service Stating that his penis was shrinking. Upon returning to the village, he had heard about the symptoms of his companions, who had entered the icy water To relieve.
While this patient drank alcohol from time to time, he stated that he had been sober for the last two weeks and no records were found In their medical records.
With this case the outbreak was reactivated and 11 more cases appeared among mill workers. The nephew Of the 53 year old patient also had Koro's syndrome a few days after his uncle.
After a further medical intervention, the outbreak was controlled after six or seven days.
Although the underlying mechanisms are still not well understood, this massive behavior could be explained by the theory of mirror neurons.
This is a special type of neurons that have been found in the human brain and other primates, and would be in charge of"observing"the behavior of Other individuals of the species and imitate their behavior.
These neurons could play a very important role in imitation learning, but then their function would be inhibited to prevent the person from going Out there imitating everything that others do.
However, in cases of massive Koro, the inhibition of these neurons would fail and in this way the syndrome could spread from person to person.
Diagnosis of Koro's syndrome
To make the diagnosis, a complete medical review, including psychosexual aspects and psychiatric history of the patient, should be performed.
The physician should investigate whether the patient is concerned about their appearance or body image, to rule out body dysmorphic disorder.
It is also important to inquire about the patient's beliefs and values, or what he thinks about his genitals or his sex life.
And of course, you also have to rule out any actual injury or alteration that may be happening to the genitals. There may be injuries Inflicted by the same patient, in an attempt to avoid retraction of his penis, which helps to guide the diagnosis.
In summary, if the patient declares that his genitals are shrinking even if no physical abnormalities are found, if he presents a large Anxiety, believes that it can die and uses mechanisms to prevent retraction, then it is Koro primary.
If any of these symptoms are missing but others are present, then it may be Koro secondary or Koro incomplete, which is usually the one Appears in Western countries.
Treatment
In Koro's cases associated with cultural beliefs, the symptoms disappear with Psychological therapy And can be prevented by providing information on Anatomy and proper sex education.
In Western Koro cases, sexual conflicts and mental illnesses that may be the cause of symptoms should be sought. The treatment Psychological and psychiatric to follow will depend on what the situation of the patient.
Curiosities
The Koro syndrome is more prevalent than you think, and in some Asian countries there were major epidemics not so many years ago.
For example, in certain regions of China the Koro is considered endemic and there were large outbreaks in 1948, 1955, 1966 and 1974, coinciding with periods of great Uncertainty and social tension in the country.
In 1984 and 1985 there was an epidemic of Koro that lasted more than a year and affected more than 3 thousand people in different cities. To end the outbreak, Conducted a mental health campaign and since then, there have been no more epidemics in China.
The social and economic improvements in the country certainly also helped to reduce outbreaks.
In 1967 there was another major case of massive Koro in Singapore, which lasted approximately ten days. Some media reported that Some people had had symptoms of Koro after eating pork that had received the vaccine for swine flu.
These rumors soon expanded and shortly afterwards a hospital in the region treated 97 cases of Koro's syndrome in a single day.
The government and medical authorities stopped the outbreak by making public announcements on TV and newspapers about falsifying information Published.
Cases of genital retraction in Nigeria and other African countries were also reported in the 1970s and 1980s, and small outbreaks were still detected in 1996. African victims interpret the symptoms as a"robbery"of their genitals: a person with whom they had sex would have"taken" Their organ and their spiritual essence, provoking them sexual impotence.
The alleged explanations for Koro's symptoms can be very variable and depend on people's cultural beliefs.
Look at this curious example:
A 40-year-old Greek patient comes to the emergency department of a hospital indicating that he feels pain and burning in the penis ratio, And that it is retracting toward your abdomen.
According to him, the symptoms are being triggered by a"virus"that has lived in his penis during the last 18 years, after having sex With a prostitute. Throughout those 18 years, the patient had presented symptoms of Koro repeatedly.
After the medical examination, it was determined that he suffered Major depression With psychotic features and that this underlying disease is what actually Was causing Koro's syndrome in this person.
In general terms, Koro's syndrome is a rare condition, but its symptoms, the references that patients make and the way in which they Can be"infected"without doubt are very interesting.
What is your experience with koro syndrome? What treatment do you follow? Your opinion will help readers. Thanks!