Int J Sports Med 2001; 22(6): 410-413
DOI: 10.1055/s-2001-16248
Physiology and Biochemistry

© Georg Thieme Verlag Stuttgart · New York

Impotence and Genital Numbness in Cyclists

F. Sommer1 , D. König2 , C. Graf3 , U. Schwarzer1 , C. Bertram2 , T. Klotz1 , U. Engelmann1
  • 1Department of Urology
  • 2Department of Orthopedic Surgery, University Medical Center of Cologne, Cologne, Germany
  • 3Institute of Cardiology and Sports Medicine, University of Cologne, Cologne, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Cyclists often complain of genital numbness and even of impotence. The purpose of this study was to determine if perineal compression during cycling causes changes in the penile blood supply, impotence and penile numbness. Forty healthy athletic men with a mean age of 30±5.3 years took part in the study. Transcutaneous penile oxygen pressure was obtained using a device consisting of a modified Clark pO2 electrode, attached to the glans of the penis. All men were measured in a standing position before, in a seated and standing position during and in a standing position after cycling. Additionally, a detailed interview was carried out with each man. The penile blood supply - which correlates with the transcutaneous pO2 at the glans - decreased significantly in over 70 % of the test subjects during cycling in a seated position. Cycling in a standing position did not show any alteration in the penile blood supply as compared to the values measured before exercising. Numbness of the genital region was reported by 61 % of the cyclists. 19 % of cyclists who had a weekly training distance of more than 400 km complained of erectile dysfunction. The results of the present study showed that there is a deficiency in penile perfusion due to perineal arterial compression. This could be a reason for penile numbness and impotence in long-distance cyclists. Therefore, we suggest restricting the training distance, and taking sufficient pauses during the course of prolonged and vigorous bicycle riding, in order to avoid penile numbness and impotence.

References

  • 1 Anderson K E, Wagner G. Physiology of penile erection.  Physiol Rev. 1995;  75 191-236
  • 2 Anderson K V, Bovin G. Impotence and nerve entrapment in long distance amateur cyclists.  Acta Neurol Scand. 1997;  95 233-240
  • 3 Benet A E, Melman A. The epidemiology of erectile dysfunction.  Urol Clin N Am. 1995;  22 699-709
  • 4 Bloch W, Klotz T, Sedlaczek P, Zumbé J, Engelmann U, Addicks K. Evidence for the involvement of endothelial nitric oxide synthase from smooth muscle cells in erectile function of human corpus cavernosum.  Urol Research. 1998;  26 129-136
  • 5 Braun M, Klotz T, Reifenrath B, Wassmer G, Schwarzer U, Engelmann U. KEED - erster deutschsprachig validierter Fragebogen zur Erfassung der männlichen sexuellen Funktion.  Akt Urol. 1998;  9 300-305
  • 6 Burke E R. Proper fit of the bicycle.  Clin Sports Med. 1994;  13 1-14
  • 7 Desai K M, Gingell J C. Hazards of long distance cycling.  B M J. 1989;  298 1072-1073
  • 8 Feldmann H A, et al. Impotence and its medical and psychosocial correlates: results of Massachusetts Male Aging Study.  J Urol. 1994;  151 54-61
  • 9 Gaskell P. The importance of penile blood pressure in cases of impotence.  Can Med Assoc J. 1971;  105 1047-1051
  • 10 Goodson J D. Pudendal neuritis from biking (letter).  N Engl J Med. 1981;  304 365
  • 11 Hippocrates. Airs Waters Places. Ch. XXI-XXII. In: Jones WHS (ed.) Hippocrates with an English translation. London; William Heinemann 1923 I: 125-131
  • 12 Jünemann K P, Persson-Jünemann, C, Tanagho E A, Alken P. Neurophysiology of penile erection.  Urol Res. 1989;  17 213-217
  • 13 Kedia K R. Vasculogenic impotence diagnosis and objective evaluation using quantitative segmental pulse volume recorder.  Br J Urol. 1984;  56 516-520
  • 14 Lue T F, Hricak H, Marich K W. Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis.  Radiology. 1985;  155 777-781
  • 15 Mellion M B. Common cycling injuries. Management and prevention.  Sports Med. 1991;  11 52-70
  • 16 McDonald D I. Is there life after genital numbness?.  N Z Med J. 1987;  100 465
  • 17 McDowell J W, Thiede W H. Usefullness of transcutaneous pO2 monitor during exercise testing in adults.  Chest. 1980;  78 853-855
  • 18 Moreland R B. Is there a role of hypoxemia in penile fibrosis?.  lnt J Impotence Res. 1998;  10 113-120
  • 19 Munarriz R M, et al. Blunt trauma: the pathophysiology of hemodynamic injury leading to erectile dysfunction.  J Urol. 1995;  153 1831-1840
  • 20 Nayal W, Schwarzer U, Klotz T, Heidenreich A, Engelmann U. Transcutaneous penile oxygen pressure during bicycling.  Br J U International. 1999;  83 623-625
  • 21 Nehra A, Goldstein I, Pabby A, Nugent M, Huang Y H, de las Morenas A, Krane R J, Udelson D, Saenz de Tejada I, Moreland R B. Mechanisms of venous leakage: a prospective clinicopathological correlation of corporeal function and structure.  J Urol. 1996;  156 1320-1329
  • 22 Paky F, Helms P, Cheriyan G. Transkutane Sauerstoff- und Kohlendioxidmessung bei pädiatrischen lntensivpatienten.  Monatsschr Kinderheilkd. 1985;  133 879-881
  • 23 Schwarzer U, Wiegand W, Bin-Saleh A, Lötzerich H, Kahrmann G, Klotz T, Engelmann U. Impotence rate in long distance cyclists.  J Urol. 1999;  161 686A
  • 24 Shafik A. Pudendal artery syndrome with erectile dysfunction: treatment by pudendal canal decompression.  Arch Androl. 1995;  34 83-94
  • 25 Sharlip I D. Penile arteriography in impotence after pelvic trauma.  J Urol. 1980;  126 477-481
  • 26 Solomon S, Cappa K G. Impotence and bicycling. A seldom-reported connection.  Postgrad Med. 1987;  81 99-102

Oberarzt Dr. F. Sommer

Klinik und Poliklinik für Urologie der Universität zu Köln

Joseph-Stelzmann-Str. 9
50924 Köln
Germany


Phone: +49 (221) 478-4687

Fax: +49 (221) 478-6256

Email: Frank.Sommer@uni-koeln.de

    >