Cutting Off the Nose to Save the Penis

Abstract

Introduction The average bicycle police officer spends 24 hours a week on his bicycle and previous studies have shown riding a bicycle with a traditional (nosed) saddle has been associated with urogenital paresthesia and sexual dysfunction. Aim The objective of this study was to assess the effectiveness of the no-nose bicycle saddle as an ergonomic intervention and their acceptance among male bicycle police officers. Methods Bicycle police officers from five U.S. metropolitan areas were recruited for this study. Officers completed: (i) the International Index of Erectile Function Questionnaire (IIEF); (ii) computerized pressure measurements at the points of contact on the bicycle; the handlebars, the pedals, and the saddle; (iii) one night of nocturnal Rigiscan® assessment; (iv) penile vibrotactile sensitivity threshold assessed by computerized biothesiometery. Officers selected a no-nose saddle for their bicycles and were asked to use the intervention saddle exclusively for 6 months, at which point they were retested. Main Outcome Measures Perineal pressure, urogenital numbness, penile vibrotactile sensitivity threshold, erectile function as measure by International Index of Erectile Function Questionnaire (IIEF) and Rigiscan. Results After 6 months, 90 men were reassessed. Only three men had returned to a traditional saddle. The results are presented for those who used the no-nose saddle continuously for 6 months. There was a 66% reduction in saddle contact pressure in the perineal region (P < 0.001). There was a significant improvement in penis tactile sensation (P = 0.015). There was a significant improvement in erectile function assessed by IIEF (P = 0.015). There were no changes noted in the Rigiscan® measures. The number of men indicating they had not experienced urogential paresthesia while cycling for the preceding 6 months, rose from 27% to 82% using no-nose saddles. Conclusion (i) With few exceptions, bicycle police officers were able to effectively use no-nose saddles in their police work. (ii) Use of no-nose saddles reduced most perineal pressure. (iii) Penile health improved after 6 month using no-nose saddles as measured by biothesiometry and IIEF. There was no improvement in Rigiscan® measure after 6 months of using no nose saddles, suggesting that a longer recovery time may be needed.

Assessing the reproductive health of men with occupational exposures

“…The assessment of erectile function using the Rigiscan ® has been used successfully in the occupational setting in studies of bicycle patrol officers 66121…”

Biomechanical Comparison of Shorts With Different Pads

“…To evaluate the reduction in such loads pressure sensor mats resulted to be the more indicated systems and thus they have been employed in previous investigations. 10 – 13 From a physiological point of view the capacity of different saddle shapes to reduce perineal pressure was indirectly quantified measuring the penile oxygen pressure. 7 , 14 For this aim the most indicated instrument is the oxymeter.…”

A novel method to determine perineal artery occlusion among male bicyclists

“… Lowe, Schrader & Breitenstein (2004) applied pressure mats to bicycle seats and measured pressure distribution underlying the perineal region during stationary bicycling and concluded that the “no-nose” design reduced the pressure exerted on the perineum without leading to an increase shift in pressure on the pedals or handlebars. Schrader, Breitenstein & Lowe (2008) in a prospective study of male bicyclists who changed from a traditional “nose” seat to a “no-nose” seat for six months, noted improvements in International Index of Erectile Function Questionnaire, urogenital numbness, and penile vibrotactile sensitivity threshold.…”

“…In order to accomplish this, we devised a novel device to record pressures exerted directly on the perineum, rather than on the bicycle seat itself as has been performed in past studies. In these previous studies, it was asserted that no such technology existed to discriminate pressure exerted by the posterior regions of the thigh from the contact force affecting the soft tissues of the perineum in a real-world setting ( Schrader, Breitenstein & Lowe 2008) . By locating the perineal arteries with Doppler ultrasound probes and measuring the arterial occlusion pressure, we sought to translate the pressure exerted on the perineum during bicycle riding into a more clinically meaningful variable.…”