The scenes are real and may be shocking to some indeed, even after 20 years. The nightlife, and especially the sex-scene of Japan is explored with nothing censored. There are some scenes from other countries as well, namely Thailand, and I believe Myanmar.
Prostitute-client encounters are shown several times, and so are some rare fetishes.
Unlike other 'shock films', such those from Italy ( Cannibal Holocaust), this one was entirely shot on real subjects and not actors. This is what gives it unique value.
It is a hard-to-find piece, but if you can get your hands on a copy, do it. You won't regret it