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Rare Diseases: Koro, Genital Retaction Syndrome by mike961

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· @mike961 · (edited)
$12.85
Rare Diseases: Koro, Genital Retaction Syndrome
<br>Stereotypes are a curious thing. I have always been against them; firstly because of my aversion to all kinds of generalizations, I think that the human race, and we as individuals, is far too complex for our personality and essence to be summed up in a few sentences. And secondly, because I believe that I do not adhere to any stereotype that could be applied to me, be it by nationality, race, sex or profession. However, and this is something that many of us may find difficult to admit, most stereotypes have at least a little truth in them, after all, they had to come from somewhere, and that somewhere is usually a distorted and exaggerated truth. Many times, these stereotypes that we all know and try to ignore, with varying success, can even change our behavior or way of being, the way we perceive a certain population, and believe it or not, they can also affect our health, fortunately for medical bloggers such as yours truly. Today I present one of these cases, a mental illness common in Asia known as **Koro:**
<br>

# <center>Rare Diseases: Koro, Retractile Penis Syndrome</center>

<center><img src="https://images.pexels.com/photos/1799305/pexels-photo-1799305.jpeg?auto=compress&amp;cs=tinysrgb&amp;dpr=2&amp;h=650&amp;w=940"></center><div class="pull-left">[*Source: Pexels*](https://www.pexels.com/es-es/foto/1799305/)</div><div class="pull-right">*License: Public Domain*</div>
<br>
### <center>*Surely you understand the difficulty in finding appropriate images for this article, we will have to make due with a variety of phallic objects.*</center>

<br>
It is hardly a secret the fact fact that many times we base our appearance, or our personality changes, to adapt to what others expect of us; if we feel we belong to a certain group, sometimes we adapt our way of dressing or talking to fit better with them. Possibly this is a survival mechanism inherited from our ancestors, after all, it is not a new phenomenon, it surely comes from the very beginnings of humanity. A wonderful example of this fact can be found in, of all things, the *Mafia*, [whose way of acting changed based on movies like *The Godfather*](https://www.theage.com.au/entertainment /movies/why-hollywood-is-married-to-the-mob-20100913-158dl.html), where they were made to look like men of honor adhering to a code of silence, when in fact, before the film - and the book that inspired it -  few mobsters were interested in keeping the *Omerta*. These behavioral changes based on stereotypes and preconceptions can occur slowly and insidiously, without us noticing, and taking root in our subconscious so that they become a reality. Put simply, we are shaped by the culture that surrounds us. And this applies even for diseases, if not, ask those who suffer from Koro.

<br>
The Koro syndrome, name that is believed to come from the Malay word *"Kura"* which means "head of the turtle" or from *"Keruk"*; "to shrink" is a [culture bound](https://es.wikipedia.org/wiki/S%C3%ADndrome_cultural) psychiatric disorder in which the patient suffers the delirious belief that his penis is shrinking and retracting towards his abdomen, which will eventually cause kill him. Needless to say, this causes tremendous anguish, anxiety, and possibly a desire to buy Hummer trucks and exercise for hours as a compensatory mechanism. Koro is endemic in countries of Southeast Asia, mainly in China, where it is known as *shuk yang*, being documented for the first time in a book published during the Qing Dynasty, which reigned from 1636 to 1912. However, cases have also been described in the west of the African continent, and in Europe and North America, where it is currently known as Genital Retraction Syndrome.

<br>
<center><img src="https://upload.wikimedia.org/wikipedia/commons/thumb/1/17/Phallus_hadriani.jpg/506px-Phallus_hadriani.jpg"></center><div class="pull-left">[*Source: Wikipedia*](https://en.wikipedia.org/wiki/File:Phallus_hadriani.jpg)</div><div class="pull-right">*License: Public Domain*</div>

<br>
Each culture has a different explanation for its **_cause_**: the Chinese said that this condition was caused by a loss of *yang* energy, based on the theory of ying and yang, and was treated with hot herbal infusions according to the classification of the "four natures". In medieval times, Europeans believed that witches had the power to magically shrink or disappear men's penises, and that after that the disarticulated member was able to move by itself and ate grains of corn like a living being *([seriously](http://www.malleusmaleficarum.org/part-ii-question-i-chapter-vii/), I could not make this up if I tried)*, which would have made *Harry Potter* even more entertaining. More recently, inoculation of vaccines *(in Singapore)*, food poisoning and poisoned tobacco *(in Thailand)* and again, witchcraft *(in Africa)* have been blamed as the cause for Koro epidemics. But of course, the truth is much simpler; like all culture-bound psychiatric syndromes, it is caused by constant suggestions specific to the culture in which it is presented. Once a person thinks he is affected, when he notices a *(imaginary)* decrease in the size of his or her sexual organs, it is enough for that case to be known in the community so that an epidemic emerges, a phenomenon known as [mass hysteria.](https://steemit.com/steemstem/@mike961/medical-mysteries-the-dance-epidemic-of-1518)

<br>
Its **_symptomatology_** is quite specific: all those affected have the mistaken belief that their sexual organs, the penis in men, and the labia or nipples in women, are shrinking and retreating towards the inside of their body , which will end up killing them. The idea of imminent death causes anxiety attacks that can last anywhere from a few hours to a couple of days, however, there are cases of chronic Koro; in which the symptoms persist for years. It is common for those affected to try to prevent the retraction of their organs using penis pumps, or even tying weights to the glans with a rope. The effectiveness of these measures is, at most, doubtful, as your friend with the huge truck and who spends all day in the gym, and who is clearly making up for something, can confirm.

<br>
<center><img src="https://upload.wikimedia.org/wikipedia/commons/thumb/d/d8/3_x_Small_eggplant_2017_B.jpg/800px-3_x_Small_eggplant_2017_B.jpg"></center><div class="pull-left">[*Source: Wikimedia Commons*](https://commons.wikimedia.org/wiki/File:3_x_Small_eggplant_2017_B.jpg)</div><div class="pull-right">*License: Public Domain*</div>

<br>
The **_diagnosis_**, as in most psychiatric illnesses, is based on an interview in which certain criteria must be met in order to arrive at a definitive diagnosis, and a physical examination in which it is confirmed that there are no real changes in the organs sexual, looking for the presence of physical diseases such as Peyronie's disease, or hypospadias. A differential diagnosis must be made with other conditions such as [body dysmorphic disorder](https://en.wikipedia.org/wiki/Body_dysmorphic_disorder), or [penile dysmorphophobia](https://www.ncbi.nlm.nih.gov/m/pubmed/15967261/). In addition, one must inquire about the religious beliefs and the cultural background of the patient, remembering that Koro is a cultural syndrome.

<br>
The **_treatment_** is based on psychological therapy adjusted to the particular needs and beliefs of the patient. He is lectured on anatomy and sexology to try to supplant cultural superstitions with scientific facts, explaining the impossibility of his condition and what he is really suffering. It is also useful to give talks on adequate sexual education in those communities on which there is a case of Koro, to prevent possible epidemics of mass hysteria.

<br>
<center><img src="https://upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Torre_Agbar_-_Barcelona%2C_Spain_-_Jan_2007.jpg/242px-Torre_Agbar_-_Barcelona%2C_Spain_-_Jan_2007.jpg"></center><div class="pull-left">[*Source: Wikimedia Commons*](https://commons.wikimedia.org/wiki/File:Torre_Agbar_-_Barcelona,_Spain_-_Jan_2007.jpg)</div><div class="pull-right">*License: Public Domain*</div>

<br>
It is a fact that our beliefs, both religious and cultural, at least initially, are a product of our environment and upbringing. Afterwards it may be possible to change them according to our personal experiences, but most of the time at least a small part of all that which was instilled in our childhood stays with us, and as can be demonstrated by the existence of this condition, if these superstitions are negative, they are capable of affecting our well-being. For this reason, it is important not to stay only with what we are told, and always go further and investigate on our own everything that we think might not be entirely true. Curiosity is a virtue, which should never be suppressed. Finally, I would like to end with a phrase that a future colleague, specialist in General Surgery, and a true eminence in his area, once told me: "curiosity will not kill the cat, ignorance will."

# References:

* [Koro – a Culture-bound Depersonalization Syndrome](https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/koroa-culturebound-depersonalization-syndrome/71825E0147DEA89DC4FECAADA5589664) 

* [Koro – Culture Bound Syndrome](http://anthropology.msu.edu/anp204-us13/2013/07/19/koro-culture-bound-syndrome/)

* [Koro Syndrome: The Genital Retraction Fear](https://www.medicaldaily.com/koro-syndrome-genital-retraction-fear-242674)

* [Koro – ScienceDirect](https://www.sciencedirect.com/topics/neuroscience/koro)

* [Culture Bound Syndrome – Wikipedia](https://en.wikipedia.org/wiki/Culture-bound_syndrome)

* [Body dysmorphic disorder – Wikipedia](https://en.wikipedia.org/wiki/Body_dysmorphic_disorder)
 ***
<center>*If you enjoy medical-themed articles, or general curiosities, remember to follow me, there is much more on the way! And as always, I leave my thanks to @steemstem and @air-clinic for their constant support to all scientific content; you inspire us to keep improving.*</center>
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@mathowl ·
$0.05
8e8y2pf3z
I think the images are very appropriate :D

(I am tagging @trumpman for obvious reasons)
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@mike961 ·
$0.04
Thanks, I had the idea after a few minutes looking at very explicit photos, and thinking that they would get me banned, at best. Don't do a Google inage search for "Genital Retraction" with the filter off. Really.

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@alexander.alexis ·
g29jrpt8d
Come on, you know everyone will do it now!
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@trumpman ·
$0.06
I like dicks
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@alexander.alexis ·
$0.03
e0ykae220
Who doesn't?
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@chappertron ·
$0.04
Hey mike, thanks for the entertaining article. Even though diseases like this are probably not that fun. Anyway, grain eating penises are definitely funny somehow.

>In medieval times, Europeans believed that witches had the power to magically shrink or disappear men's penises, and that after that the disarticulated member was able to move by itself and ate grains of corn like a living being (seriously, I could not make this up if I tried), which would have made Harry Potter even more entertaining.

I think the age rating for the movies should, in these cases, be reassessed.

Best

Chapper
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@alexander.alexis ·
3yimvi0uo
We've been eating gluten using the wrong head, that's why we're intolerant.
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@mike961 ·
$0.03
I died with this comment, you made my day sir. 

And thanks @chappertron! Different age rating, but it would have been worth it. Think about it; replace every *expelliarmus* with *dickspelliarmus*.

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@steemstem ·
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<div class='text-justify'> <div class='pull-left'> <center> <br /> <img width='200' src='https://res.cloudinary.com/drrz8xekm/image/upload/v1553698283/weenlqbrqvvczjy6dayw.jpg'> </center>  <br/> <br /> </div>

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@alexander.alexis ·
$0.10
8u7joypu0
> I think that the human race, and we as individuals, is far too complex for our personality and essence to be summed up in a few sentences.

A [new study](https://neurosciencenews.com/meaningless-psychiatric-diagnosis-14434) finds psychiatric diagnoses that lump people into groups to be rather unscientific.

> He is lectured on anatomy and sexology to try to supplant cultural superstitions with scientific facts, explaining the impossibility of his condition and what he is really suffering. It is also useful to give talks on adequate sexual education in those communities on which there is a case of Koro, to prevent possible epidemics of mass hysteria.

Religion is also sometimes called a mass hysteria. It's interesting that scientists don't think that *all* superstitious belief should be supplanted with scientific fact, just the ones that bother their possessor.
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@mike961 ·
$0.02
Thanks for your comment @alexander.alexis, and for sharing that study! Indeed, it's one thing to diagnose a physical illness, after all, our bodies don't differ that much from each other, and even those differences can be observed and quantified. But our mind and conciousness is subjective, and every one is unique. How can we expect to group and classify psychiatric conditions when we cannot quantify the characteristics of thoughts and ideas? Hell, we don't even know how conciousness really works. 

And well, I personally kind of share that view on religion. But as with regular diseases, if it doesn't cause harm (normally), there's no problem with just letting it be.

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@utopian-io ·
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@steemitboard ·
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@agmoore2 ·
$0.05
h8f2pzr20
I may be the one woman who responds here....I found your illustrations hilarious and your approach to the subject equally entertaining. Not easy to handle this in a way that is both classy and significant.  You did it. 
Never heard of this before. The human psyche will always astonish.  
Great article, wonderful writing.  
👍  , , ,
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vote details (4)
@mike961 ·
$0.04
Thank you so much @agmoore2, I'm glad you liked it! Indeed, that's why I enjoy reading about psychology and psychiatry, just when you think it's getting boring, you find conditions like this.

Posted using [Partiko Android](https://partiko.app/referral/mike961)
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@abigail-dantes ·
$0.07
5u3k06t92
Hello @mike961 :)

What a funny (the images!), interesting and above all well written post you have shared with us here! The introduction to the topic and the way you discussed stereotypes at the beginning really grabbed my interest. Further, I liked very much that you highlighted the importance of cultural and religious backgrounds in diagnostic processes, and how you concluded pointing out the extent to which it is essential, for our own subjective well-being, to think critically about the stories we are told as we grow up.

Absolutely beautiful work :)
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@marleyn ·
Great article I did not know anything about this
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@jaichai ·
Enjoyed reading your factual description - as well as your opinions - of this condition.

Namaste, JaiChai
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@frejafri ·
this is soo crazy! What about thinking that it is growing and gonna explode! Oh, that kind of does exist...
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