Koro-Like Syndrome in an Iranian 50 Years Old Man; Is It A Variant Caused by Cultural Issues?

Koro syndrome is a psychiatric disorder characterized by acute anxiety of one's genital retraction. In this culture-bound syndrome, originally reported in south and East Asia, the male individual believes that his penis is shrinking and deeply fears from its retraction into the abdomen and the resulted death. Here in this report we describe a patient of age 50 as first Iranian diagnosed with koro-like syndrome. He presented with the belief that his penis is shrinking gradually for the last three months and a persistent fear that it will subsequently be lost. He also reported Benign Prostatic Hyperplasia (BPH) which he refused treatment with Tamsulosin because of the fear that it would affect his penis and make it smaller. Compared to previously reported Koro symptoms, our patient reveals those characterized as main Koro features except for the fear of death with an addition al manifestation attributed to another culture-bound syndrome called “Dhat”. The case was found to be a variant of Koro that is not described before in literature. More attention could help us better understand the syndrome.