Genital retraction phenomenon in Angola: between Koro syndrome, urological pathologies, and physiological responses to climate

Abstract

Introduction: In 2026, cases of alleged "disappearance" or "retraction" of genital organs attributed to witchcraft practices were reported in Angola (provinces of Moxico, Lunda Norte, Malanje, and Luanda). The objective was to analyze this phenomenon from a multidisciplinary perspective, comparing cultural interpretations with transcultural psychiatry and human physiology. Materials and methods: An exploratory qualitative approach was adopted, based on a narrative literature review and documentary analysis of global cases and contemporary media reports. Differential diagnosis was performed between Koro syndrome, physiological thermoregulatory responses, and organic urological pathologies. Results: The global chronology of outbreaks documents massive epidemics in Asia (China, Singapore, India) and sporadic cases in Europe, North America, and Africa. In Angola, police authorities concluded that there was no clinical evidence of anatomical alterations, attributing the cases to misinformation with social impact. It was identified that penile shrinkage due to cold is a normal physiological phenomenon of vasoconstriction (dartos muscle, sympathetic nervous system T11-L2), without a pathological basis. The actual organic causes of retraction include obesity (enlarged penis), hypogonadism, Peyronie's disease, pelvic surgeries, and aging. Discussion: Angolan cases resemble Koro-like manifestations of a psychogenic nature and collective sociogenic panic, amplified by social networks in contexts of social vulnerability and low health literacy, differentiating them from classic Asian epidemics. Conclusions: The phenomenon in Angola lacks an anatomopathological basis, being a complex psychosocial manifestation that requires integrated strategies of risk communication, community education, and misinformation monitoring.