KORO SYNDROME:A condition in which patient complains Shrinkage of Genitalia

Koro is a culture-specific syndrome that is recognized in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders. The term for the condition, also known as shuk yang, shook yong, and suo yang (simplified Chinese: 缩阳; traditional Chinese: 縮陽);jinjinia bemar; or rok-joo (Thai: โรคจู๋), is to describe an individual overcome with the belief that his/her external genital—or, in female, nipple—are retracting or shrinking, with fear of that the organ will disappear, and can cause their death.

Though the syndrome is rooted in China, cases are found worldwide. Episodes of epidemics occurred in the endemic nations. In a different cultural setting, mass hysteria of genital-shrinkage have been reported in African nations.

Sign and Symptoms:

Most of the victims complain about episodes of acute attack of genital retraction or genital shrinkage, sometimes both. Each episode usually lasted several hours, though the duration can be as long as two days.There are cases in which koro symptoms persist for years with either chronic and continuous or recurrent history.On top of retraction, other symptoms include a perception of alteration of penis shape, loss of penile muscular tone; in some cases when sufferers have no perception of retraction, they may complain of genital paraesthesia or genital shortening. The cardinal breast symptom is nipple retraction, in most cases into the breast mass.

Ideational components of koro anxiety neurosis include fear of impending death, penile dissolution and loss of sexual power. These cognitions of impending death with retraction and perceived spermatorrhea has a strong cultural link with Chinese traditional beliefs, as demonstrated by the fact that in general, Asians with complaints of genital retraction believe that the condition is fatal, unlike most Westerners.Other ideational themes are intra-abdominal organ shrinkage, sex change to female or eunuch, non-specific physical danger, urinary obstruction, sterility, impending madness, spirit possession and a feeling of being bewitched.

Causes: .

Psychosexual conflicts, personality factors, and cultural beliefs are considered as being of etiological significance to koro. Sexual adjustment histories of non-Chinese victims are often significant, such as premorbid sexual inadequacy, sexual promiscuity, guilt over masturbation and impotence.

Diagnosis

Several criteria are typically used to make a diagnosis of koro: penile (or breast) retraction, anxiety related to the retraction, fear of death as a result of retraction, and use of mechanical means to prevent full retraction. Cases that do not meet all the requirements are generally classified as koro-like symptoms or given a diagnosis of partial koro syndrome. It has been argued that the criteria are sufficient but not necessary to make a diagnosis of koro.

Treatment

Medicine

Genital examination reveals no actual instances of penis shrinkage or retraction. Any actual injury or damage that occurs to individuals usually arises from overly zealous attempts at preventing retraction, and treatment on the injury should be performed.

In historical culture-bound cases, reassurance and talks on sexual anatomy are given.Patients are treated with psychotherapy distributed according to symptoms and to etiologically significant points in the past. Prognosis appears to be better in cases with a previously functional personality, a short history and low frequency of attacks, and a relatively uncomplicated sexual life.

Indigenous treatment

For sporadic Western cases, careful diagnostic workup including searching for underlying sexual conflict is recommended. The choice of psychotherapeutic treatment is based on the psychiatric pathology found.

In China, traditional treatment based on the causes suggested by cultural beliefs are administrated to the patient. Praying to gods and asking Taoist priests to perform exorcism is common. If a fox spirit is believed to be involved, people may hit gongs or beat the person to drive it out. The person will receive a yang- or yin-augmenting Chinese medicine potion, usually including herbs, animal penises (of tiger,deer and fur seal), pilose antler (stag of deer) or deer tail. Other foods for therapy are pepper soup, ginger soup and liquor.