This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brock, G. Search for Related Content PubMed PubMed Citation Articles by Brock, G.

Editorial Commentary

Erectile Function of Bike Patrol Officers

Schrader SM, Breitenstein MJ, Clark JC, Lowe BD, Turner TW. Nocturnal penile tumescence and rigidity testing of bicycle patrol officers. J Androl.2002 ;23:927–934.[Abstract/Free Full Text]

The clear strengths of this report rest on the authors' ability to measure the perceived amount of ED (via RigiScan and questionnaires) and the objective pressure measurements obtained in different seating positions of the study populations.

The weaknesses of this report are significant and limit the authors' conclusions. The method through which the affected population was selected provides us with little insight into how prevalent this condition is among general cyclists. The self-selective nature of their study populations may provide an exaggerated estimate of how commonly cycling affects EF. The control group for this study is almost 5 years younger than the "experimental" group and consists of a number insufficient to provide meaningful comparisons. The authors state clearly in their "Results" section that a very weak negative association was seen between time on the bike, days/wk ridden, and average seat pressure with RigiScan-documented nocturnal penile tumescent events. No statistical differences were measured using the RigiScan for erectile quality.

Use of the International Index of Erectile Function (IIEF) to evaluate EF is an accepted sensitive and specific psychometrically validated tool. In the present study, both cyclists and control-group members rated within the normal range (>25 points in the EF domain). Although one could argue that these results may represent very early ED, a large cohort of subjects chosen at random and evaluated for the variables in this study may provide a more meaningful assessment of the role played by cycling in EF.

Because of these limitations, a definitive statement concerning the etiology of erectile difficulties among cycling patrol officers is not possible. The association between sleep time tumescence, hours on the bike, and perineal pressure is very tenuous. This association may have changed (either positively or negatively) had more nights of RigiScan testing been performed or a greater number of subjects been evaluated.

In spite of these shortcomings, this study provides us with novel insights into the potential impact of chronic perineal pressure and EF. I concur with the authors' statements that 1) it seems reasonable to recommend breaks out of the saddle, particularly when genital numbness is experienced, and 2) the use of saddles without protruding noses should be considered. New saddle design may be optimized through the use of the methodology described in this study in order to evaluate the location and amounts of perineal pressure. Definitive patient-cycling guidelines and recommendations will require larger, detailed investigations based on objective evidence establishing a clear physiologic basis to cycling-associated ED. Until that information is available, common sense approaches toward the patient concerned about ED, such as those outlined above, seem reasonable.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brock, G. Search for Related Content PubMed PubMed Citation Articles by Brock, G.