Bicycle Riding and the Bedroom: Can Riding a Bicycle Cause Erectile Dysfunction?

Michiels, Mathias; Aa, Frank Van der

doi:10.1016/j.urology.2014.12.034

Cited by 10 publications

(12 citation statements)

References 38 publications

(42 reference statements)

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“…Surgery should be reserved for patients failing conservative treatment only and achieves good functional outcome. Counseling patients to change to a modified bike saddle that causes less perineal compression could be useful [35]. A number of patients were diagnosed with hypercoagulability disorder and some authors have advocated routine screening for these disorders in IPT patients [22].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature

Weyne¹,

Schillebeeckx²,

Jamaer³

et al. 2015

The Journal of Sexual Medicine

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Introduction Idiopathic partial thrombosis (IPT) of the corpus cavernosum is a rare condition. The etiology is not fully understood; however, the presence of an either or not congenital web in these patients may contribute to the development of IPT. Aim The aim of this study was to describe 18 new IPT cases and compare these with 38 cases found in the literature. Methods A multicenter retrospective analysis was performed. Descriptive statistics are given. Main Outcome Measures The main outcome measures used were clinical presentation, clinical and radiographical diagnostics, treatment and resolution of symptoms. Results Patients most frequently presented with perineal swelling (10/18; 56%) and pain (13/18; 72%), unilateral (12/18; 67%) or bilateral (4/18; 22%), and pain during erection (10/18; 72%). Penile curvature, dysuria or fever (each 1/18; 6%) were uncommon presenting symptoms. In our series, magnetic resonance imaging demonstrated a fibrous web in the corpus cavernosum in 100% of cases and was more bilaterally (11/18; 61%) than unilaterally (7/18; 39%) diagnosed. Cycling was found to be a provocative factor for IPT occurrence in patients at risk as 61% (11/18) of patients reported being a frequent cyclist with the episode of IPT occurring immediately after or during cycling activity in 8 out of 18 patients (8/18; 44%). In five centers, 15 patients were treated conservatively, the majority being treated with therapeutic doses of low molecular weight heparin and simultaneous anti-aggregant therapy. In one center, all three patients were treated with a surgical approach. Complete resolution of symptoms was noted in only 50% of cases. Conclusion IPT is a condition that presents typically with perineal pain and swelling. Cycling is often seen as a provocative factor, while the presence of a fibrous web at the level of the crurocavernosal junction is the underlying disorder allowing for entrapment of blood in the crura. Conservative treatment provides a reasonably good outcome in most cases. For therapy resistant cases, surgery can be considered.

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Section: Discussionmentioning

confidence: 99%

Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature

Weyne¹,

Schillebeeckx²,

Jamaer³

et al. 2015

The Journal of Sexual Medicine

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“…Few investigators have studied the association of genital numbness and ED [5,6,[15][16][17]. Somner et al [5] studied the vascular hypothesis of ED aetiology by measuring transcutaneous glans penis oxygen pressure in 40 cyclists in standing and sitting positions.…”

Section: Association Of Genital Numbness Cycling and Edmentioning

confidence: 99%

The association of bicycle‐related genital numbness and Sexual Health Inventory for Men (SHIM) score: results from a large, multinational, cross‐sectional study

et al. 2018

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“…Thus, cycling over rough road will likely generate a changing repetitive force of the type associated with nerve dysfunction in animal models, 10 and in human beings could incur pudendal nerve palsies hypothesized to cause genital numbness in cyclists. 17 …”

Section: Discussionmentioning

confidence: 99%

“…Despite a relatively small increase in recorded pressure in this area, any saddle changes resulting in a re-distribution of this pressure may contribute to increases in genital numbness and associated ED noted in men using cutout saddles. 17 , 20 It also has implications for saddle angle and body position. A relatively upright position was used for this study; given the known relationship between forward tilt and pressure on the AP, 16 we postulate a more forward-leaning position (in both genders) may increase the pressure on the AP during oscillation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Oscillation on Perineal Pressure in Cyclists: Implications for Micro-Trauma

Sanford¹,

Gadzinski²,

Gaither³

et al. 2018

Sexual Medicine

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BackgroundGenital numbness and erectile dysfunction in cyclists may result from repeated perineal impacts on the bicycle saddle (micro-trauma) that occur during routine cycling.AimTo evaluate the relationship between oscillation forces and perineal pressures among cyclists in a simulated laboratory setting.MethodsParticipants were fit to a study bicycle to ensure all cyclists had the same torso angle (60 ± 1 degree) and maximum knee angle (150 ± 1 degree). A lever system was used to generate oscillation events of 3 progressively increasing magnitudes. Perineal pressure was continuously measured using a pressure sensor on the bicycle saddle. This process was carried out in each of the following conditions: (1) stationary (not pedaling) with the standard seatpost, (2) pedaling with standard seatpost, (3) stationary with seatpost shock absorber, and (4) pedaling with seatpost shock absorber.OutcomesWe compared perineal pressure changes during oscillation events in the stationary and pedaling states, with and without the seatpost shock absorber.ResultsA total of 39 individuals were recruited (29 men and 10 women). As the amount of oscillation increased from an average of 0.7g (acceleration due to Earth’s gravity) to 1.3g, the perineal pressure increased from 10.3% over baseline to 19.4% over baseline. There was a strong linear relationship between the amount of oscillation and increase in pressure (r2 = 0.8, P < .001). A seatpost shock absorber decreased the impact of oscillation by 53% in the stationary condition. Men and women absorbed the majority of shock in areas corresponding to pelvic bony landmarks.ConclusionThis study represents one of the first characterizations of cycling-associated perineal micro-trauma in a laboratory setting. We found a strong linear relationship between oscillation magnitude and perineal pressure during cycling, which was mitigated by a seatpost shock absorber. The use of shock absorption in bicycle design may reduce perineal micro-trauma and potentially improve cycling-associated perineal numbness and erectile dysfunction.Sanford T, Gadzinski AJ, Gaither T, et al. Effect of Oscillation on Perineal Pressure in Cyclists: Implications for Micro-Trauma. Sex Med 2018;6:239–247.

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Bicycle Riding and the Bedroom: Can Riding a Bicycle Cause Erectile Dysfunction?

Cited by 10 publications

References 38 publications

Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature

Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature

The association of bicycle‐related genital numbness and Sexual Health Inventory for Men (SHIM) score: results from a large, multinational, cross‐sectional study

Effect of Oscillation on Perineal Pressure in Cyclists: Implications for Micro-Trauma

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