Dec. 10, 1999 (Atlanta) -- What was once suspected has now been confirmed -- and bicycle riding among men may never be the same.
The 44-year-old man had been riding about 3,000 miles per year, but cut back to half that because of the persistent numbness. His symptoms first started 2 years earlier after he injured himself in the groin while bicycle riding. He never went to the doctor, but did drop his mileage down -- which seemed to "cure" the problem. However, once he started long-distance riding again, the numbness returned.
Using nerve conduction studies, the researchers diagnosed chronic, moderate damage to both the right and left branches of the pudendal nerve -- one of the main nerves serving the genital region -- due to compression. The research appears in the latest issue of the Journal of Urology.
"This is a reminder to bicyclists that they take their sex lives in their hands when they ride bicycles," Irwin Goldstein, MD, tells WebMD. "The problem is, to ride a bicycle well, when you get your head down in the "aero" position, the body weight is on the crotch. There's a straddle. The problem is there are many nerves, arteries, and veins in the crotch that you basically injure." Goldstein, one of the study authors, is associated with the Boston Medical Center.
"It has been a recognized clinical entity," urologist Craig Donatucci, MD, tells WebMD. "This study did a diagnostic test to document it. Will it change the way I treat these patients? No. If I have a patient who's a bicycler and is reporting impotence, I tell them to change the bicycle seat first." Donatucci is an associate professor of urology at Duke University in Durham, N.C.
While better-padded seats may be of some help, Goldstein argues that they're not dealing with the basic problem. He explains there's only one place on the human body that's evolved to tolerate full sitting weight, and that's the area of the buttocks, which is covered with fat and muscle. The crotch, by contrast, is coursed with vulnerable nerves, arteries, and veins, which are of key importance to the proper functioning of the penis.
But study co-author Allen D. Seftel, MD, from Case Western Reserve University in Cleveland, says casual bikers aren't at great risk for developing nerve problems -- only those putting in heavy mileage. Still, among those men, it's a common complaint. If they numbness or erectile dysfunction develop, Seftel advises laying off or cutting back on bicycling for a time; replacing the bike seat with one offering more padding -- and seeing a urologist if the symptoms don't clear up within about 3 months.
Goldstein agrees that long-distance riders are most at risk, but offers a caveat. "You can, on a single ride, land on the bicycle straddle [the seat] or the top tube and become impotent the rest of your life." He says that danger is a very real one -- even for young boys.
- Researchers have diagnosed chronic, moderate damage to nerves in the genital region that was caused by compression from bicycle riding.
- Casual bikers are not at great risk for developing nerve problems, but it is possible that a single fall onto the seat or top tube can cause long-term damage.
- If cyclists experience symptoms such as numbness or erectile dysfunction, they should cut back on mileage, buy a seat with more padding, and see a urologist.