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Bicycle Saddle Shape Affects Penile Blood Flow

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Bicycle Saddle Shape Affects Penile Blood Flow International Journal of Impotence Research (2002) 14, 513–517 ß 2002 Nature Publishing Group All rights reserved 0955-9930/02 $25.00 www.nature.com/ijir Bicycle saddle shape affects penile blood flow S-J Jeong1, K Park2*, J-D Moon3 and SB Ryu2 1Research Institute of Clinical Sciences, Chonnam National University Medical School, Gwangju, Republic of Korea; 2Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea; and 3Department of Occupational and Environmental Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea The purpose of this study was to evaluate the effect of bicycle saddle shape on penile blood flow during cycling. Penile blood flow was measured using a laser Doppler flowmeter in 20 potent male volunteers. In a counterbalanced, crossover design, measurements were taken in the standing and sitting positions, on either a narrow unpadded or wide unpadded saddle, before and after cycling for 5 min. Before cycling, penile blood flow (ml=min=100 g tissue) was significantly decreased from 1.6 Æ 0.7 to 1.5 Æ 0.7 (P ¼ 0.010) on the wide saddle and from 1.7 Æ 0.6 to 1.0 Æ 0.5 (P < 0.001) on the narrow saddle. After 5 min of cycling, the changes in penile blood flow on the wide and narrow saddles were 0.34 Æ 0.49 and 70.38 Æ 0.49, respectively (P < 0.001). The narrow saddle is associated with more significant reductions in penile blood flow and could be a source of blunt perineal trauma, potentially leading to erectile dysfunction. International Journal of Impotence Research (2002) 14, 513–517. doi:10.1038=sj.ijir.3900929 Keywords: saddle; cycling; penile blood flow; laser Doppler flowmetry; erectile dysfunction Introduction development of such symptoms. Furthermore, cur- rent bicycle saddle designs may be responsible for chronic injury to the perineum and thus may pose as Evidence, in the form of anecdotal evidence, case a risk factor for erectile dysfunction. reports and questionnaire-based studies, has accu- Some previously published, questionnaire-based mulated on patients who exercise on bicycles and studies2 and case reports5 have reiterated many of complain of impotence or erectile dysfunction. In the typical clinical symptoms. Very few studies, light of the popularity of cycling as a fitness activity however, reported direct measurements of blood as well as a competitive sport, the potential impact flow in the flaccid penis during cycling. of cycling as an etiological factor in the development The purpose of this study was to investigate the of erectile dysfunction is significant. However, relationship between the shape of the bicycle saddle relatively little attention has been devoted to and penile blood flow during cycling using laser elucidating the specific relationship between Doppler flowmetry. cycling and erectile dysfunction or the relevant pathophysiology. It has been proposed that the bicycle saddle might affect penile blood flow during cycling.1 Genital Materials and methods numbness and impotence have been reported in some long-distance bicycle riders,2 and blunt trauma to the corpora cavernosa has been considered to be a A total of 20 healthy, potent, male volunteers (mean risk factor for the subsequent development of age, 23 y; range, 20 – 26) participated in this study. erectile dysfunction.1,3,4 It seems that anatomical All subjects underwent routine evaluation for considerations of the structures compressed by the impotence. All were free of any clinical history of load placed on the bicycle saddle might explain the impotence, had no remarkable findings on routine blood profiles, and had no history of diabetes, Peyronie’s disease or vascular disease. In a counterbalanced, crossover design, all parti- cipants rode the same ergometer, while only the *Correspondence: K Park, Department of Urology, Chonnam saddle was changed between an unpadded narrow National University Medical School, 8-Hak-dong, Dong-Ku, Gwangju 501-757, Republic of Korea. type and an unpadded wide type. Baseline penile E-mail: [email protected] blood flow was measured in the standing position Received 13 February 2002; Revised 04 June 2002; before beginning cycling. The effect of the bicycle accepted 12 July 2002 saddle was assessed by measuring the penile blood Saddle shape affects penile blood flow S-J Jeong et al 514 flow in the seated position before and after cycling and pre-exercise values in a single position (seated for 5 min on each saddle. Pedaling resistance was or standing). Significant differences between means held constant for all subjects, and the participants were identified from values determined by the were instructed to pedal at 40 rpm while remaining paired t-test. Differences were considered statisti- seated throughout the 5 min period. The volunteer cally significant for a two-tailed hypothesis was allowed to rest for 5 – 10 min between the two (P < 0.05). Statistical analyses were performed using types of saddles. SPSS 10.1 (Chicago, IL, USA) The bike saddles used in this study are pictured in Figure 1. The transverse diameters at the widest points were 14 and 26 cm for the narrow and wide Results saddles, respectively. Both were constructed of the same materials and were assumed to vary only in terms of the surface area available for distribution of Trends in alterations of penile blood flow were weight. As illustrated in Figure 1, the narrow saddle similar on both saddles with respect to position. The shares the typical piriform shape seen in commer- data are summarized in Table 1. At a given time cially available narrow saddles. The wide saddle is point, the simple act of sitting on either type of more heart-shaped. saddle significantly reduced penile blood flow Penile blood flow was measured using a laser below baseline values, while blood flow signifi- Doppler flowmeter (Transonic Systems Inc., Ithaca, cantly increased with cycling. However, the two NY, USA). A surface-type flow probe was placed on types of bicycle saddles affected penile blood flow the glans penis and was held in place using differently in that sitting on the narrow saddle adhesive tape. The flow probe was connected to caused significantly greater reductions in blood flow the laser Doppler flowmeter, which was calibrated than on the wide saddle both before and after against an internal standard. Readings of blood flow cycling (P < 0.001 in both). Penile blood flow after were in units of ml=min=100 g tissue. cycling in the seated position on the narrow saddle Penile blood flow measurements were taken in was the only post-cycling condition in which the the standing and sitting positions just prior to blood flow decreased below the baseline value. beginning exercise and immediately upon cessation Baseline penile blood flow measurements (in of exercise. All measured values and calculated ml=min=100 g tissue) were arbitrarily defined as values are reported as mean Æ s.d. in units of those recorded while standing prior to bicycling. ml=min=100 g tissue. Disparities in effect of postural They were recorded with the subject standing erect change (sitting or standing) and cycling (before and with a flaccid penis. There was no statistically after) were determined by calculating the changes in significant difference in the baseline values of blood flow. The effect of postural change is subjects using either the wide or narrow saddles expressed as the difference between sitting and (1.6 Æ 0.7 and 1.7 Æ 0.6, respectively). standing values on a given saddle. The effect of Penile blood flow was significantly decreased by exercise is expressed as the difference between post- simply sitting on the saddle from 1.6 Æ 0.7 to 1.5 Æ 0.7 on the wide saddle (P ¼ 0.010) and from 1.7 Æ 0.6 to 1.0 Æ 0.5 on the narrow saddle (P < 0.001). The mean changes in penile blood flow prior to exercise by sitting on the wide and narrow saddles were 70.12 Æ 0.19 and 70.68 Æ 0.47, respectively. Sitting on the narrow saddle resulted in significantly greater reductions in penile blood flow (P < 0.001). When the penile blood flow was measured with the subject seated on the saddle after 5 min of bicycling, the blood flows were 1.9 Æ 0.9 and 1.3 Æ 0.5 on the wide and narrow saddles, respec- tively (P ¼ 0.009, P < 0.001 vs baseline, respec- tively). The decrease in blood flow on either saddle proved to be significant when compared both to the respective post-exercise standing values and baseline values (P ¼ 0.001, P < 0.001 vs standing after exercise, respectively). Also, the decrease in blood flow resulting from sitting on the narrow saddle was significantly greater than on the wide Æ Æ < Figure 1 Photograph of the narrow and wide saddles. The saddle (70.84 0.66 vs 70.19 0.21, P 0.001). narrow saddle measured 14 cm in width at its widest points. The After 5 min of bicycling, penile blood flow wide saddle was 26 cm at its widest points. significantly increased above baseline values to International Journal of Impotence Research Saddle shape affects penile blood flow S-J Jeong et al Table 1 Summary of recorded penile blood flow measurement (in ml/min/100 g tissue) on each saddle type 515 Wide saddle Narrow saddle Before cycling After cycling Effect of Before cycling After cycling Effect of (%Baseline) (%Baseline) exercise (%)a (%Baseline) (%Baseline) exercise (%)a Standing 1.6 Æ 0.7b,c 2.1 Æ 0.9 0.51 Æ 0.48 1.7 Æ 0.6b 2.2 Æ 0.9 0.46 Æ 0.83 (100) (131) (32) (100) (129) (27) Sitting 1.5 Æ 0.7 1.9 Æ 0.9 0.45 Æ 0.49 1.0 Æ 0.5 1.3 Æ 0.5 0.30 Æ 0.52 (94) (119) (30) (59) (76) (30) Effect of posture (%)a 70.12 Æ 0.19 70.19 Æ 0.21 0.34 Æ 0.49c 70.68 Æ 0.47 70.84 Æ 0.66 70.38 Æ 0.49c (77.5) (79.0) (21)d (740) (738) (722)d aEffect of posture is the difference between sitting and standing values.
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