Cycling offers important health benefits and should be encouraged

Saddle Pressures Factors in Road and Off-Road Cyclists of Both Genders: A Narrative Review

The contact point of the pelvis with the saddle of the bicycle could generate abnormal pressure, which could lead to injuries to the perineum in cyclists. The aim of this review was to summarize in a narrative way the current literature on the saddle pressures and to present the factors that influence saddle pressures in order to prevent injury risk in road and off-road cyclists of both genders. We searched the PubMed database to identify English-language sources, using the following terms: "saddle pressures", "pressure mapping", "saddle design" AND "cycling". We also searched the bibliographies of the retrieved articles. Saddle pressures are influenced by factors such as sitting time on the bike, pedaling intensity, pedaling frequency, trunk and hand position, handlebars position, saddle design, saddle height, padded shorts, and gender. The jolts of the perineum on the saddle, especially on mountain bikes, generate intermittent pressures, which represent a risk factor for various pathologies of the urogenital system. This review highlights the importance of considering these factors that influence saddle pressures in order to prevent urogenital system injuries in cyclists.

Urogenital and Sexual Complaints in Female Club Cyclists-A Cross-Sectional Study

INTRODUCTION

Cycling has gained increased popularity among women, but in contrast to men, literature on urogenital overuse injuries and sexual dysfunctions is scarce.

AIM

To determine the prevalence and duration of urogenital overuse injuries and sexual dysfunctions in female cyclists of the largest female cycling association in The Netherlands.

METHODS

A cross-sectional questionnaire survey was sent to 350 members of the largest female Dutch cycling association and 350 female members of a Dutch athletics association (runners).

MAIN OUTCOME MEASURES

The prevalence and duration of urogenital overuse injuries and sexual complaints were assessed using predefined international definitions.

RESULTS

Questionnaire results of 114 cyclists (32.6%) and 33 runners (9.4%) were analyzed. After at least 2 hours of cycling, dysuria, stranguria, genital numbness, and vulvar discomfort were present in 8.8%, 22.2%, 34.9%, and 40.0%, respectively (maximum duration 48 hours). These complaints are not present in the controls (P < .001). In multivariable logistic regression analysis, increased saddle width was significantly associated with the presence of dysuria and stranguria. Older age was significantly associated to the presence of vulvar discomfort. Of the cyclists, 50.9% has at least one urogenital overuse injury. Insertional dyspareunia was present in 40.0% of cyclists and lasted until 48 hours after the effort. The latter complaint was not present in runners (P < .001). Uni- or bilateral vulvar edema was reported by 35.1% of cyclists. As for general complaints, 18.4% of cyclists reported a change in sexual sensations and 12.8% reported difficulties in reaching orgasm owing to cycling-related complaints. Limitations include population size and the use of non-validated questionnaires.

CONCLUSIONS

The results of this study suggest that urogenital overuse injuries and sexual complaints are highly prevalent in female cyclists who are active participants in riding groups.

Victims of road rage: a qualitative study of the experiences of motorists and vulnerable road users

OBJECTIVE

To gain an in-depth understanding of road rage incidents from the victims' perspectives.

METHODS

The data consisted of 30- to 60-min in-depth semistructured phone interviews with 29 self-identified victims of road rage. Twenty of the participants were in a motor vehicle, whereas 9 were pedestrians/cyclists. A qualitative Grounded Theory approach was used to inductively code and analyze the transcripts.

RESULTS

Victims reported a correlation between their vulnerability and the perceived intensity/severity of the road rage incidents. The most vulnerable victims (pedestrians and cyclists) were the least likely to view road rage incidents as a random event and the most likely to feel that they were specifically targeted. Road rage incidents tended to evolve more rapidly when there was a greater real or perceived power imbalance between the victims and perpetrators. The most vulnerable victims were the most likely to have long-term physical and mental health consequences from the incident, and to significantly modify their behavior after the incident.

CONCLUSIONS

Our analysis suggests that issues of victim vulnerability play a major role in determining the intensity, severity, and psychological consequences of road rage incidents. This seems particularly true for the most vulnerable of road users, such as pedestrians and cyclists.

Does bicycle riding impact the development of lower urinary tract symptoms and sexual dysfunction in men?

Purpose

This study was designed to determine whether men who engaged in recreational bicycle riding are more likely to be affected by lower urinary tract symptoms (LUTS) and sexual dysfunction than are man who exercised by amateur marathon running with less perineal impact.

Materials and Methods

A total of 22 healthy male amateur bicyclists and 17 healthy male amateur marathoners were enrolled in the study. We evaluated questionnaires including the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF), serum prostate-specific antigen (PSA), uroflowmetric values, postvoid residual (PVR) urine volume, and transrectal ultrasound of the prostate in all subjects. We also compared the prevalence of urination disorders (UD) and erectile dysfunction (ED).

Results

There were no significant differences between the two groups in age, body mass index, comorbidities, or exercise habits (p>0.05). Mean total and subscale scores of the IPSS and IIEF and the prevalence of UD (8/22 vs. 4/17, p=0.494) and ED (11/22 vs. 10/17, p=0.748) were not significantly different between the two groups. Also, there were no significant differences between the two groups in uroflowmetric parameters such as peak urinary flow rates, voided urine volume, PVR urine volume, prostate volume, or serum PSA level.

Conclusions

Bicycle riding seems to have no measurable hazardous effect on voiding function or sexual function in men who cycled recreationally.

The Vicious Cycling: Bicycling Related Urogenital Disorders

PURPOSE

Bicycle riding is one of the most popular means of transportation, recreation, fitness and sports among millions of people of all ages who ride on road and off road, using a variety of bicycle types. It is also a readily available form of aerobic non-impact exercise with established cardiovascular beneficial effects. Bicycles are also a common source of significant injuries. This review focuses upon the specific bicycling related overuse injuries affecting the genitourinary tract.

MATERIALS AND METHODS

MEDLINE search of the literature on bicycling and genitourinary disorders was performed using multiple subject headings and additional keywords. The search yielded overall 62 pertinent articles. We focused primarily on the most prevalent related disorders such as pudendal nerve entrapment, erectile dysfunction and infertility. The potential effect of bicycling on serum PSA level was also discussed in depth in view of its recognized clinical importance. Infrequent disorders, which were reported sporadically, were still addressed, despite their rarity, for the comprehensiveness of this review.

RESULTS

The reported incidence of bicycling related urogenital symptoms varies considerably. The most common bicycling associated urogenital problems are nerve entrapment syndromes presenting as genitalia numbness, which is reported in 50-91% of the cyclists, followed by erectile dysfunction reported in 13-24%. Other less common symptoms include priapism, penile thrombosis, infertility, hematuria, torsion of spermatic cord, prostatitis, perineal nodular induration and elevated serum PSA, which are reported only sporadically.

CONCLUSIONS

Urologists should be aware that bicycling is a potential and not an infrequent cause of a variety of urological and andrological disorders caused by overuse injuries affecting the genitourinary system.

Bicycle helmets — does the dental profession have a role in promoting their use?

OBJECTIVES

To review the available literature regarding the: epidemiology of bicycle related head injuries; consequences of head injuries; rates of cycle helmet use; impact of educational campaigns and legislation on usage rates; effectiveness of cycle helmets in protecting against head and facial injuries; arguments against the compulsory use of bicycle helmets.

DATA SOURCES

A computerised Medline search was conducted using the keywords: head injury, facial injury, bicycle helmets, accidents.

DATA SELECTION

All available information was considered.

DATA SYNTHESIS

Data was collated manually.

CONCLUSIONS

The wearing of bicycle helmets contributes significantly to the prevention of head injuries (HI) and traumatic brain injury (TBI), particularly in children and adolescents. There is evidence to support the role of cycle helmets in the prevention of injuries to the middle third of the face and some dental injuries. There is a case for the implementation of legislation accompanied by educational campaigns to increase significantly the use of cycle helmets. The dental profession could: play an active role in promoting cycle helmet use; support calls for the compulsory wearing of cycling helmets, particularly for children; press for modification of helmet design and standards to increase protection of the face.

Does bicycling contribute to the risk of erectile dysfunction? Results from the Massachusetts Male Aging Study (MMAS)

An association between bicycling and erectile dysfunction (ED) has been described previously, but there are limited data examining this association in a random population of men. Such data would incorporate bicyclists with varied types of riding and other factors. Data from the Massachusetts Male Aging Study (MMAS) were utilized to examine the association between bicycling and ED. Logistic regression was used to test for an association, controlling for age, energy expenditure, smoking, depression and chronic illness. Bicycling less than 3 h per week was not associated with ED and may be somewhat protective. Bicycling 3 h or more per week may be associated with ED. Data revealed that there may be a reduced probability of ED in those who ride less than 3 h per week and ED may be more likely in bikers who ride more than 3 h per week. More population-based research is needed to better define this relationship.