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Saulicz M, Saulicz A, Saulicz E. Self-Assessment of Lower Urinary Tract Condition in Female Competitive Cyclists. Healthcare (Basel) 2024; 12:1163. [PMID: 38921278 PMCID: PMC11202815 DOI: 10.3390/healthcare12121163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased intraabdominal pressure. This situation has the potential to adversely affect pelvic floor function. Therefore, the aim of this study was to assess the incidence of lower urinary tract symptoms (LUTSs) in female competitive road cyclists and cross-country cyclists. The study included 76 female competitive road cyclists and cross-country cyclists and 76 women not practising competitive sport. The Core Lower Urinary Tract Symptom Score (CLSS) questionnaire was used to assess the lower urinary tract condition. Female competitive cyclists had a statistically significantly higher LUTSs score (95% CI: 3.12-4.2 vs. 2.31-3.16; p < 0.05) compared to women not practising competitive sports. Female cyclists had a statistically significantly higher overall CLSS score (95% CI: 3.99-5.61 vs. 2.79-3.97; p < 0.05). Female cyclists had a statistically significantly higher incidence and severity of urinary frequency (p < 0.05 and p < 0.02), urge (p < 0.001 and p < 0.02) and stress incontinence (p < 0.001 and p < 0.001), and pain in the bladder (p < 0.01 and p < 0.01), while physically inactive women recorded a statistically higher incidence of slow urinary stream (p < 0.01 and p < 0.04). A statistically significant association was recorded between the years of cycling and the number of hours per week spent on training and the number of symptoms and their severity. The number of natural births experienced by women involved in competitive cycling significantly affects the severity of LUT symptoms. Compared to women not practising competitive sports, competitive female cyclists are found to have a higher prevalence of LUTSs and a greater degree of severity. LUTSs in competitive female cyclists are negatively influenced by years of competitive career and weekly number of training hours and the number of natural births experienced.
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Affiliation(s)
- Mariola Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Aleksandra Saulicz
- School of Public Health & Social Work, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia
| | - Edward Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
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Mayer JM, Spies SI, Mayer CK, Zubler C, Loucas R, Holzbach T. How to Treat a Cyclist's Nodule?-Introduction of a Novel, ICG-Assisted Approach. J Clin Med 2024; 13:1124. [PMID: 38398438 PMCID: PMC10889187 DOI: 10.3390/jcm13041124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Perineal nodular induration (PNI) is a benign proliferation of the soft tissue in the perineal region that is associated with saddle sports, especially road cycling. The etiology has not been conclusively clarified; however, repeated microtrauma to the collagen and subcutaneous fat tissue by pressure, vibration and shear forces is considered a mechanical pathomechanism. In this context, chronic lymphedema resulting in the development of fibrous tissue has been suggested as an etiological pathway of PNI. The primary aim of this study was to introduce and elucidate a novel operative technique regarding PNI that is assisted by indocyanine green (ICG). In order to provide some context for this approach, we conducted a comprehensive review of the existing literature. This dual objective aimed to contribute to the existing body of knowledge while introducing an innovative surgical approach for managing PNI. METHODS We reviewed publications relating to PNI published between 1990 and 2023. In addition to the thorough review of the literature, we presented our novel surgical approach. We described how this elaborate approach for extensive cases of PNI involves surgical excision combined with tissue doubling and intraoperative ICG visualization for exact lymphatic vessel obliteration to minimize the risk of recurrence based on the presumed context of lymphatic congestion. RESULTS The literature research yielded 16 PubMed articles encompassing 23 cases of perineal nodular induration (PNI) or cyclist's nodule. Of these, 9 cases involved females, and 14 involved males. Conservative treatment was documented in 7 cases (30%), while surgical approaches were reported in 16 cases (70%). Notably, a limited number of articles focused on histopathological or radiological characteristics, with a shortage of structured reviews on surgical treatment options. Only two articles provided detailed insights into surgical techniques. Similarly to the two cases of surgical intervention identified in the literature research, the post-operative recovery in our ICG assisted surgical approach was prompt, meaning a return to cycling was possible six weeks after surgery. At the end of the observation period (twelve months after surgery), regular scar formation and no signs of recurrence were seen. CONCLUSION We hope that this article draws attention to the condition of PNI in times of increasing popularity of cycling as a sport. We aimed to contribute to the existing body of knowledge through our thorough review of the existing literature while introducing an innovative surgical approach for managing PNI. Due to the successful outcome, the combination of tissue doubling, intraoperative ICG visualization and postoperative negative wound therapy should be considered as a therapeutic strategy in cases of large PNI.
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Affiliation(s)
- Julius M. Mayer
- Department of Plastic and Hand Surgery, Inselspital, University Hospital Bern, 3010 Bern, Switzerland;
| | - Sophie I. Spies
- Department of Dermatology and Allergy, Technical University Munich, 80802 Munich, Germany
| | - Carla K. Mayer
- Department of Urology, Spital Thurgau, 8500 Frauenfeld, Switzerland
| | - Cédric Zubler
- Department of Plastic and Hand Surgery, Inselspital, University Hospital Bern, 3010 Bern, Switzerland;
| | - Rafael Loucas
- Department of Hand and Plastic Surgery, Spital Thurgau, 8500 Frauenfeld, Switzerland; (R.L.); (T.H.)
| | - Thomas Holzbach
- Department of Hand and Plastic Surgery, Spital Thurgau, 8500 Frauenfeld, Switzerland; (R.L.); (T.H.)
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Zapletal J, Nanka O, Halaska MJ, Maxova K, Hajkova Hympanova L, Krofta L, Rob L. Anatomy of the pudendal nerve in clinically important areas: a pictorial essay and narrative review. Surg Radiol Anat 2024; 46:211-222. [PMID: 38240796 DOI: 10.1007/s00276-023-03285-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/14/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE The pudendal nerve is an anatomical structure arising from the ventral branches of the spinal roots S2-S4. Its complex course may be affected by surrounding structures. This may result in irritation or entrapment of the nerve with subsequent clinical symptoms. Aim of this study is to review the anatomy of the pudendal nerve and to provide detailed photographic documentation of the areas with most frequent clinical impact which are essential for surgical approach. METHODS Major medical databases were searched to identify all anatomical studies investigating pudendal nerve and its variability, and possible clinical outcome of these variants. Extracted data consisted of morphometric parameters, arrangement of the pudendal nerve at the level of roots, formation of pudendal nerve, position according to sacrospinal and sacrotuberal ligaments and its terminal branches. One female cadaver hemipelvis was dissected with common variability of separate course of inferior rectal nerve. During dissection photodocumentation was made to record course of pudendal nerve with focus on areas with recorded pathologies and areas exposed to iatrogenic damage during surgical procedures. RESULTS Narrative review was done to provide background for photodocumentation. Unique photos of course of the pudendal nerve was made in areas with great clinical significance. CONCLUSION Knowledge of anatomical variations and course of the pudendal nerve is important for examinations and surgical interventions. Surgically exposed areas may become a site for iatrogenic damage of pudendal nerve; therefore, unique picture was made to clarify topographic relations.
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Affiliation(s)
- Jan Zapletal
- Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Srobarova 1150/50, 100 34, Prague 10, Czech Republic.
| | - O Nanka
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 3, 128 00, Prague 2, Czech Republic
| | - M J Halaska
- Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Srobarova 1150/50, 100 34, Prague 10, Czech Republic
| | - K Maxova
- Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Srobarova 1150/50, 100 34, Prague 10, Czech Republic
| | - L Hajkova Hympanova
- Institute for the Care of Mother and Child Prague, Third Faculty of Medicine, Charles University, Podolske nabrezi 157, 147 00, Prague, Czech Republic
| | - L Krofta
- Institute for the Care of Mother and Child Prague, Third Faculty of Medicine, Charles University, Podolske nabrezi 157, 147 00, Prague, Czech Republic
| | - L Rob
- Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Srobarova 1150/50, 100 34, Prague 10, Czech Republic
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Napier DN, Rankin A, Heron N. Infographic. Getting to the bottom of saddle sores: an infographic. Br J Sports Med 2023; 57:1469-1470. [PMID: 37433585 DOI: 10.1136/bjsports-2023-106911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Daniel Nicholas Napier
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Alan Rankin
- Sports Medicine, SportNI Sports Institute, Newtownabbey, UK
- Department of Medicine, Sports Medicine NI, Belfast, UK
| | - Neil Heron
- General Practice/Centre for Public Health, Queen's University Belfast, Belfast, UK
- School of Medicine, Keele University, Staffordshire, UK
- British Cycling, Manchester, UK
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Amend GM, Nabavizadeh B, Enriquez A, Hakam N, Shaw N, Breyer BN. The Effect of Bike Seat Models on Perineal Pressure During Cycling: Implications for Patients After Lower Genitourinary Reconstructive Surgery. Urology 2023; 179:174-180. [PMID: 37247695 DOI: 10.1016/j.urology.2023.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To understand the effect of bicycle saddle shape and size on the pressure transmitted to the perineum, as prolonged perineal pressure and microtrauma amongst avid cyclists may increase the risk for complications following lower genitourinary surgery. METHODS We tested five seats (Bontrager, Waterloo, WI) with varying levels of padding and morphology (comfort, fitness, fitness gel, race, and performance) for two different riders. The seats were installed on a Peloton stationary exercise bike (New York City, NY). Force measurements were performed using a 9833E-50 Large F-Socket Sensor (Tekscan, South Boston, MA). We measured total and perineal forces in three conditions at the same resistance: (a) at rest (not pedaling); (b) at 8mph; (c) at 15mph. RESULTS Significant differences across the bicycle seats were observed with fitness gel seats providing the lowest perineal pressure. In all measurements, perineal forces were significantly lower at 15mph compared to 8mph (P < .001). When a rider used an oversized seat, less force was exerted compared to the appropriate size at both 8mph (P < .001) and 15mph (P < .001) speeds. Conversely, an undersized seat significantly increased perineal pressures at both 8mph (P = .018) and 15mph (P = .007). CONCLUSION Larger seats constructed of more impressionable materials absorb a greater total force and act to distribute the subject's weight thereby delivering less force to the perineum. More perineal pressure is delivered at lower speeds and at rest likely due to the cyclist lifting off the seat during times of strenuous activity.
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Affiliation(s)
- Gregory M Amend
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Behnam Nabavizadeh
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Anthony Enriquez
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Nizar Hakam
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Nathan Shaw
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA
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Vicari DSS, Patti A, Giustino V, Figlioli F, Alamia G, Palma A, Bianco A. Saddle Pressures Factors in Road and Off-Road Cyclists of Both Genders: A Narrative Review. J Funct Morphol Kinesiol 2023; 8:71. [PMID: 37367235 DOI: 10.3390/jfmk8020071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
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.
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Affiliation(s)
- Domenico Savio Salvatore Vicari
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Flavia Figlioli
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Giuseppe Alamia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
- Regional Sports School of CONI Sicilia, 90141 Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
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Could Horse Gait and Induced Pelvic Dynamic Loads in Female Equestrians Be a Risk Factor in Pudendal Neuralgia? Sports (Basel) 2023; 11:sports11010016. [PMID: 36668720 PMCID: PMC9865369 DOI: 10.3390/sports11010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/09/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Pudendal Neuralgia (PN) is a rare, debilitating disease caused by damage to the pudendal nerve, which innervates the anus, rectum, perineum, lower urinary tract, and genitalia. Although its etiology remains scientifically unknown, a number of sports practices, including horse-riding, are reported as triggering and/or aggravating factors. The present work summarizes the experimental measurements of the contact pressure at the interface between the rider and saddle, for a population of 12 experienced female riders. These tests reveal that dynamic horseback-riding leads to high levels of peak pressures in the perineal region, which confirms that the practice of equine sports may cause neuropathologies such as PN. All collected data will be used as boundary conditions in a future numerical 3D model aimed at locating the possible areas of pudendal nerve crushing.
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E Brito DV, Pereira-Lourenço M, Pereira JA, Eliseu M, Rabaça C. Erectile function in amateur cyclists. Arch Ital Urol Androl 2022; 94:232-236. [PMID: 35775353 DOI: 10.4081/aiua.2022.2.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/04/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Cycling is a popular means of transport and recreational activity; bicycles are also a source of genitourinary injuries and there is the idea that cycling may have a significant impact on sexual function. The objective of this study was to evaluate the effect of amateur cycling on erectile function. METHODS We used a questionnaire comparing amateur cyclists (n = 199) and footballers (n = 43), regarding sexual related comorbidities and hours of practice per week. The cyclists were also characterized in terms of road vs cross-country, breaks during cycling, saddle, and shorts. To evaluate erectile function, the International Index of Erectile Function questionnaire was applied. RESULTS there was no difference in International Index of Erectile Function total score between groups. Age and presence of erectile dysfunction associated comorbidity were negative factors in the International Index of Erectile Function score in cyclists but not in the footballers. CONCLUSIONS Cycling is usually associated with perineal numbness, but that numbness did not lead to lower International Index of Erectile Function scores. In conclusion amateur cycling has no effect on EF.
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Affiliation(s)
| | | | | | - Miguel Eliseu
- Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra.
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Getting to the Bottom of Saddle Sores: A Scoping Review of the Definition, Prevalence, Management and Prevention of Saddle Sores in Cycling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138073. [PMID: 35805731 PMCID: PMC9265698 DOI: 10.3390/ijerph19138073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/16/2022]
Abstract
Objectives: To summarise and map the existing evidence relating to the definition, prevalence, prevention and management of saddle sores within the literature and highlight research gaps. Design: Scoping review. Data Sources: Three databases were searched using an appropriate search strategy agreed on by the authors with the aid of an experienced medical librarian; these databases were MEDLINE, EMBASE and Web of Science. Eligibility Criteria: To be included in this review, studies must have made specific reference to dermatological conditions that affect the saddle area, specifically arising from cycling, in either sex. Results: Seventeen studies were selected for inclusion. Saddle sores in males were the focus of thirteen studies, with only two reporting in females. Saddle sores were defined as connective tissue lesions affecting the skin in the saddle area, which can be both acute and chronic. Commonly cited preventions were chamois cream, high quality, well-fitting cycling equipment and good personal hygiene. Management in the early stages usually involves rest. Topical and intralesional steroids and lubricating creams are recommended treatments for small saddle sores, with surgical excision an option for larger, persistent saddle sores. However, surgery and steroid use may increase risk of recurrence. Conclusions: Saddle sores are an underrepresented, male-dominated issue within the literature. There is particularly limited evidence around treatment options, including topical steroids and surgical removal. Further well-designed observational studies and/or randomised controlled trials will help provide further evidence on prevalence, prevention and treatment available in the future.
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Mobisson SK, Ikpi DE, Wopara I, Obembe AO. Cannabis sativa exacerbate testicular function by increased oxidative stress, altered male reproductive hormones, sperm quality/quantity and cellular architecture of the testis. Andrologia 2022; 54:e14492. [PMID: 35675950 DOI: 10.1111/and.14492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 11/28/2022] Open
Abstract
The illicit use of Cannabis in Nigeria is on the increase within the last 10 years and has been implicated as one of the causes of fertility disorder among young men in Nigeria. Hence, this study aimed to ascertain the reproductive impact of n-hexane extract of Cannabis sativa on male Wistar rats. Fifteen male Wistar rats weighing between 180 and 200 g were assigned into three groups of five animals each. The first group served as control, second (low dose), and third (high dose) were fed with n-hexane extract of C. Sativa at doses of 0.75 mg/100 g and 1.5 mg/100 g body weight respectively for 28 days. The administration was done via orogastric. The results revealed the mean serum gonadotropin-releasing hormone (GnRH) concentration in LD and HD was significantly lower (p < 0.05) than in control. LH was significantly higher (p < 0.01) in both LD and HD compared to control. There was a significant increase (p < 0.01) in LD and HD compared to control. Testosterone was significantly elevated in HD (p < 0.05) compared to control. Testicular reduced glutathione and Superoxide dismutase were significantly (p < 0.05) reduced in fed rats compared to control. Testicular catalase and Malondialdehyde were significantly (p < 0.05) increased in HD compared to control. Non-motile sperm count showed a significant (p < 0.001) increase in fed rats compared to control. Total sperm count was significantly (p < 0.05) reduced in fed rats than in control. There were significant (p < 0.001) increased spermatozoa with abnormal morphology in treated groups compared to control. HDL cholesterol was significantly (p < 0.05) elevated in HD compared to control. The atherogenic index was significantly (p < 0.05) reduced in the group fed with 1.5 mg/kg compared to the control. Furthermore, total cholesterol, triglyceride, VLDL-c, and LDL-c did not reveal any significant difference statistically. Histological examination of testes and epididymis of fed rats showed an empty cavity with a reduction in spermatogenesis. This study suggests that n-hexane extract of C. Sativa had more effects on the gonads compared to the higher centres and its ingestion in whatever form could impair male reproductive function.
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Affiliation(s)
- Samuel Kelechi Mobisson
- Department of Human Physiology, Faculty of Basic Medical Sciences, Madonna University, Elele, Rivers State, Nigeria
| | - Daniel Ewa Ikpi
- Department of Human Physiology, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Iheanyichukwu Wopara
- Department of Biochemistry, Faculty of Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Agona Odeh Obembe
- Department of Human Physiology, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
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Guiotto A, Spolaor F, Albani G, Sawacha Z. Could Proprioceptive Stimuli Change Saddle Pressure on Male Cyclists during Different Hand Positions? An Exploratory Study of the Effect of the Equistasi ® Device. Sports (Basel) 2022; 10:sports10060088. [PMID: 35736828 PMCID: PMC9227057 DOI: 10.3390/sports10060088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023] Open
Abstract
When pedaling, the excessive pressure on the seat has the potential to produce injuries and this can strongly affect sport performance. Recently, a large effort has been dedicated to the reduction of the pressure occurring at the saddle region. Our work aims to verify the possibility of modifying cyclists’ pedaling posture, and consequently the pressure on the saddle, by applying a proprioceptive stimulus. Equistasi® (Equistasi srl, Milano, Italy) is a wearable device that emits focal mechanical vibrations able to transform the body temperature into mechanical vibratory energy via the embedded nanotechnology. The data acquired through a pressure mapping system (GebioMized®) on 70 cyclists, with and without Equistasi®, were analyzed. Pedaling in three positions was recorded on a spin trainer: with hands on the top, hands on the drop handlebar, and hands on the lever. Average force, contact surface, and average and maximum pressure each in different regions of the saddle were analyzed, as well as integral pressure time and center of pressure. In the comparisons between hands positions, overall pressure and force variables were significantly lower in the drop-handlebar position at the rear saddle (p < 0.03) and higher in hand-on-lever and drop-handlebar positions at the front saddle (p < 0.01). When applying the Equistasi device, the contact surface was significantly larger in all hand positions (p < 0.05), suggesting that focal stimulation of the lumbar proprioceptive system can change cyclists’ posture.
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Affiliation(s)
- Annamaria Guiotto
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; (A.G.); (F.S.)
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; (A.G.); (F.S.)
| | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; (A.G.); (F.S.)
- Department of Medicine, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-8277633
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Abstract
Cycle use has grown rapidly over the last few years in the UK. British Cycling membership has increased threefold since the 2012 Olympic and Paralympic Games, and this is likely to rise in the wake of the Coronavirus pandemic. As urologists, day-to-day encounters with cyclists are commonplace, who may present with acute traumatic injuries or chronic overuse injuries. The aim of this literature review was to evaluate the effect of cycling on conditions presenting to the urology clinic, in particular those of raised prostate-specific antigen (PSA), haematuria and soft-tissue lesions (‘cyclist nodules’). Furthermore, the review aimed to summarize the relationship between cycling and pudendal nerve entrapment (PNE) syndromes. A PubMed search of the literature on cycling and genitourinary disorders was performed. The literature suggests no significant change in PSA levels after a bout of cycling. Age appears to have no effect on the change in PSA experienced following a bout of cycling, in particular when comparing those <50 years of age to those >50 years of age. Haematuria appears to be rare with cycling but has been described, even with stationary bike riding. It is imperative to exclude coexisting urinary-tract pathological conditions, and cycling-induced haematuria should always be considered a diagnosis of exclusion. Perineal nodular induration (‘cyclist nodules’) is a rare condition, related to pressure and repetitive micro-trauma between the perineum and saddle. Pudendal Nerve Entrapment (PNE) represents the most common bicycling-associated urogenital complaint. Numbness in the perineum, penis, scrotum or buttocks—‘genital numbness’—is the most common and most recognized symptom of pudendal compression. Despite several studies demonstrating a link between elite cyclists and erectile dysfunction, for the average cyclist riding may actually have a protective effect on sexual function.
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Affiliation(s)
- J Peacock
- Cheltenham General Hospital, Gloucestershire Hospitals NHS Trust, UK
| | - J Cobley
- Cheltenham General Hospital, Gloucestershire Hospitals NHS Trust, UK
| | - B Patel
- Cheltenham General Hospital, Gloucestershire Hospitals NHS Trust, UK
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13
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Parmar K, Aggarwal D, Sharma A, Tyagi S, Kumar S, Singh S, Gupta S. Long-term impact of testicular torsion and its salvage on semen parameters and gonadal function. Indian J Urol 2022; 38:135-139. [PMID: 35400863 PMCID: PMC8992720 DOI: 10.4103/iju.iju_328_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/08/2021] [Accepted: 02/05/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction: Testicular torsion is a urological emergency, and long-term outcomes of testicular torsion on infertility, hormonal function, and salvaged testicular size are unclear. Materials and Methods: We conducted an ambispective, observational study from January 2014 to December 2019. Baseline demographics, time of presentation, clinical features, and management details of all the patients of testicular torsion were recorded from the database. All the patients were followed up in the outpatient clinic for testicular size, hormone levels, semen analysis, and erectile function. Results: Of 85 patients, only 67 could be contacted and included in the final analysis. Group 1(orchiectomy) comprised 44 patients, and Group 2(salvage) had 23 patients. Follow-up duration ranged from 2 to 6 years and mean follow-up was 42 ± 12 months. The median time to presentation was significantly higher in Group 1 (48 hours) as compared to Group 2 (12 hours). The rate of testicular salvage did not vary with age of the patients. Doppler ultrasonography of the scrotum detected 92.5% of all cases of torsion. Antisperm antibody levels were within normal range in all patients. Approximately 47% of patients in the salvage group developed testicular atrophy on follow-up. Serum testosterone level was significantly lower in Group 1 and the subset of patients with testicular atrophy. Rest of the hormonal parameters, semen analysis, and erectile function were comparable between two groups. Conclusion: The time between onset and presentation is an important contributing factor in guiding testicular salvage. Even after salvage, many testes may atrophy on follow-up. Orchiectomy and testicular atrophy in the long term have negative impact on serum testosterone. The patients should be counseled for a long-term follow-up for the risk of testicular atrophy and low testosterone levels.
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Murer S, Polidori G, Beaumont F, Bogard F, Polidori É, Kinne M. Advances in the therapeutic approach of pudendal neuralgia: a systematic review. J Osteopath Med 2021; 122:1-13. [PMID: 34800013 DOI: 10.1515/jom-2021-0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/09/2021] [Indexed: 12/29/2022]
Abstract
CONTEXT Although pudendal neuralgia (PN) has received growing interest over the last few years, diagnosis remains difficult, and many different therapeutic approaches can be considered. OBJECTIVES This article aims to provide an overview of the possible treatments of PN and investigate their efficacies. METHODS Utilizing PubMed and ScienceDirect databases, a systematic review was carried out and allowed identification of studies involving patients with PN, as defined by Nantes criteria, and their associated treatments. Relevant data were manually reported. RESULTS Twenty-eight articles were selected, totaling 1,013 patients (mean age, 49 years) and six different types of interventions. Clinical outcomes, most frequently quantified utilizing the Visual Analog Scale (VAS), vary greatly with both the therapy and time after intervention (from 100 to <10%). However, neither peri nor postoperative serious complications (grade > II of Clavien-Dindo classification) are reported. Although surgery seems to provide a higher proportion of long-term benefits, identifying the most efficient therapeutic approach is made impossible by the multitude of outcome measurements and follow-up frequencies. It should also be noted that literature is sparse regarding randomized controlled trials with long-term follow-up. CONCLUSIONS Although there are a number of modalities utilized for the treatment of PN, there are no current recommendations based on treatment efficacies. This seems to be largely in part caused by the lack of standardization in outcome quantification. Future research in this field should focus on prospective cohort studies with high levels of evidence, aimed at assessing the long-term, if not permanent, benefits of available therapies.
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Affiliation(s)
- Sébastien Murer
- MATIM, UFR Sciences Exactes et Naturelles, Université de Reims Champagne-Ardenne, Campus Moulin de la Housse, Reims, France
| | | | | | - Fabien Bogard
- MATIM, Université de Reims Champagne-Ardenne, Reims, France
| | - Élisa Polidori
- ESO Paris SUPOSTEO, Higher School of Osteopathy, Paris, France
| | - Marion Kinne
- ESO Paris SUPOSTEO, Higher School of Osteopathy, Paris, France
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15
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Puleo RM, Barreveld A, Rice S, Althausen Plante AM, Kotler DH. Unique Concerns of the Woman Cyclist. Phys Med Rehabil Clin N Am 2021; 33:61-79. [PMID: 34799003 DOI: 10.1016/j.pmr.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Previously a male-dominated activity, female cyclists now make up nearly half of all cyclists in the United States. Although cycling provides a significant number of health benefits, it is an activity that carries risk of injury, both traumatic and nontraumatic. Sex differences are seen in chest trauma and breast injury, as well as pelvic, given the inherent differences in anatomy. Understanding the relationship of the bicycle to the anatomy of the rider can help mitigate risks for injury.
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Affiliation(s)
- Rozanne M Puleo
- Sports Medicine, Lynn Community Health Center, 269 Union Street, Lynn, MA 01902, USA.
| | - Antje Barreveld
- Anesthesiology, Tufts University School of Medicine, Pain Management Services, Newton-Wellesley Hospital, 2014 Washington St, Newton, MA 02462, USA
| | - Sarah Rice
- Athletico Physical Therapy, 2143 W Division St, Chicago IL 60622-3006, USA
| | - Anne M Althausen Plante
- Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Dana H Kotler
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Outpatient Center - Wellesley, 65 Walnut Street, Wellesley, Boston, MA 02481, USA
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16
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Lui H, Mmonu N, Awad MA, Namiri NK, Zheng MY, Amend GM, Eisenberg ML, Breyer BN. Association of Bicycle-Related Genital Numbness and Female Sexual Dysfunction: Results From a Large, Multinational, Cross-Sectional Study. Sex Med 2021; 9:100365. [PMID: 34049264 PMCID: PMC8240355 DOI: 10.1016/j.esxm.2021.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Cycling can lead to microtrauma due to increased perineal pressure, possibly contributing to genital numbness and sexual dysfunction in female cyclists. Aim We aim to explore the associations between cycling characteristics, female genital numbness, and female sexual dysfunction. Methods We conducted a cross-sectional study on female cyclists and sexual wellness. Participants were recruited through Facebook® advertisements and online outreach at athletic clubs. Participants were asked about their cycling characteristics, genital numbness, and female sexual function using the Female Sexual Function Index (FSFI). Univariate and multivariable linear and logistic regression were used to assess risk factors for genital numbness and the association between genital numbness and the FSFI. Outcome Measures The outcome measures were cycling characteristics, questions regarding numbness (intensity, duration, location), and the FSFI score. Results Eight-hundred and seventy-five women were included in the study. Total lifetime miles cycled, biking duration, frequency, distance, speed, and biking surface were not significantly associated with genital numbness. Higher handlebar height was associated with less numbness. The prevalence of sexual dysfunction in the cohort was 52%. Genital numbness was significantly associated with sexual dysfunction (OR: 1.43, 95% CI: 1.05 – 1.95). Sub-group analysis for location of numbness demonstrated significant increase in risk for sexual dysfunction in cyclists who described numbness aro`und the perineum (OR: 2.72, 95% CI: 1.05 – 7.02) and the vulva (OR: 1.55, 95% CI: 1.13 – 2.13). There was also a significant increase in the risk of sexual dysfunction in cyclists who reported a longer duration of numbness (OR: 6.58, 95% CI: 2.27 – 19.07). Conclusions Genital numbness is common in women who cycle and is associated with increased risk of FSD and lower average sexual response scores on FSFI. Lui H, Mmonu N, Awad MA, et al. Association of Bicycle-Related Genital Numbness and Female Sexual Dysfunction: Results From a Large, Multinational, Cross-Sectional Study. Sex Med 2021;9:100365.
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Affiliation(s)
- Hansen Lui
- Department of Urology, University of California, Davis, Sacramento, CA, USA
| | - Nnenaya Mmonu
- Department of Urology, New York University, New York, NY, USA
| | - Mohannad A Awad
- Department of Surgery, Division of Urology, University of Vermont Medical Center; Burlington, VT, USA; Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Nikan K Namiri
- Department of Urology, University California, San Francisco, San Francisco, CA, USA
| | - Micha Y Zheng
- Department of Urology, University California, San Francisco, San Francisco, CA, USA
| | - Gregory M Amend
- Department of Urology, University California, San Francisco, San Francisco, CA, USA
| | | | - Benjamin N Breyer
- Department of Urology, University California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
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17
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Clarsen B, Pluim BM, Moreno-Pérez V, Bigard X, Blauwet C, Del Coso J, Courel-Ibáñez J, Grimm K, Jones N, Kolman N, Mateo-March M, Pollastri L, López-Rodríguez C, Ortolano Ríos R, Roshon M, Hoyos Echevarría J, Madouas G, Nordhaug LP, Patricios J, Verhagen E. Methods for epidemiological studies in competitive cycling: an extension of the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport 2020. Br J Sports Med 2021; 55:1262-1269. [PMID: 33980546 DOI: 10.1136/bjsports-2020-103906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
In 2020, the IOC released a consensus statement that provides overall guidelines for the recording and reporting of epidemiological data on injury and illness in sport. Some aspects of this statement need to be further specified on a sport-by-sport basis. To extend the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sports and to meet the sport-specific requirements of all cycling disciplines regulated by the Union Cycliste Internationale (UCI). A panel of 20 experts, all with experience in cycling or cycling medicine, participated in the drafting of this cycling-specific extension of the IOC consensus statement. In preparation, panel members were sent the IOC consensus statement, the first draft of this manuscript and a list of topics to be discussed. The expert panel met in July 2020 for a 1-day video conference to discuss the manuscript and specific topics. The final manuscript was developed in an iterative process involving all panel members. This paper extends the IOC consensus statement to provide cycling-specific recommendations on health problem definitions, mode of onset, injury mechanisms and circumstances, diagnosis classifications, exposure, study population characteristics and data collection methods. Recommendations apply to all UCI cycling disciplines, for both able-bodied cyclists and para-cyclists. The recommendations presented in this consensus statement will improve the consistency and accuracy of future epidemiological studies of injury and illness in cycling.
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Affiliation(s)
- Benjamin Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Babette M Pluim
- University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
- Department of Sports Medicine, Royal Netherlands Lawn Tennis Association (KNLTB), Amstelveen, The Netherlands
| | - Víctor Moreno-Pérez
- Center for Translational Research in Physiotherapy, Miguel Hernandez University of Elche, Elche, Spain
- Medical Department, Spanish Cycling Federation, Madrid, Spain
| | - Xavier Bigard
- Medical Commission, Union Cycliste Internationale (UCI), Aigle, Switzerland
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain
| | | | - Katharina Grimm
- Medical Commission, Union Cycliste Internationale (UCI), Aigle, Switzerland
| | - Nigel Jones
- Medical Department, British Cycling, Manchester, UK
| | - Nikki Kolman
- Center for Human Movement Sciences, University Medical Centre Groningen, Groningen, The Netherlands
- Knowledge Centre for Sport & Physical Activity, Ede, The Netherlands
| | - Manuel Mateo-March
- Performance and Medical Department, Movistar Cycling team, Pamplona, Spain
| | | | | | | | - Michael Roshon
- Medical Department, USA Cycling, Colorado Springs, Colorado, USA
| | | | - Gwenaëlle Madouas
- Department of Medical Services, Fédération Française de Cyclisme, Brest, France
| | | | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
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Diagnosis, Rehabilitation and Preventive Strategies for Pudendal Neuropathy in Cyclists, A Systematic Review. J Funct Morphol Kinesiol 2021; 6:jfmk6020042. [PMID: 34068471 PMCID: PMC8162534 DOI: 10.3390/jfmk6020042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
This systematic review aims to provide an overview of the diagnostic methods, preventive strategies, and therapeutic approaches for cyclists suffering from pudendal neuropathy. The study defines a guide in delineating a diagnostic and therapeutic protocol using the best current strategies. Pubmed, EMBASE, the Cochrane Library, and Scopus Web of Science were searched for the terms: "Bicycling" OR "Bike" OR "Cyclists" AND "Neuropathy" OR "Pudendal Nerve" OR "Pudendal Neuralgia" OR "Perineum". The database search identified 14,602 articles. After the titles and abstracts were screened, two independent reviewers analyzed 41 full texts. A total of 15 articles were considered eligible for inclusion. Methodology and results of the study were critically appraised in conformity with PRISMA guidelines and PICOS criteria. Fifteen articles were included in the systematic review and were used to describe the main methods used for measuring the severity of pudendal neuropathy and the preventive and therapeutic strategies for nerve impairment. Future research should determine the validity and the effectiveness of diagnostic and therapeutic strategies, their cost-effectiveness, and the adherences of the sportsmen to the treatment.
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Paladino JR, Korkes F, Glina S. Testicular torsion and climate changes in macroregions of São Paulo, Brazil. EINSTEIN-SAO PAULO 2021; 19:eAO5472. [PMID: 33729284 PMCID: PMC7935086 DOI: 10.31744/einstein_journal/2021ao5472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/26/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: To analyze the association between climate changes in the macroregions in the state of São Paulo and testicular torsion treated cases. Methods: The cases were selected in the Brazilian Public Health Data System Database from January 2008 to November 2016. All surgical procedure records were identified by the Hospital Admission Authorization document. Two codes were selected to process the search: testicular torsion (surgical cure code) and acute scrotum (exploratory scrototomy code). The macroregions were grouped in five areas linked to climate characteristics by International Köppen Climate Classification. Results: A total of 2,351 cases of testicular torsion were registered in the period. For the areas B, C and E (testicular torsion n=2,130) there were statistical differences found in association of testicular torsion cases and decreased temperature (p=0.019, p=0.001 and p=0.006, respectively), however, in analyses for the areas A and D statistical differences were not observed (p=0.066 and p=0.494). Conclusion: Decrease in temperature was associated with testicular torsion in three macroregions of São Paulo. The findings support the theory of cold weather like a trigger in occurrence of testicular torsion in a tropical climate region.
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Affiliation(s)
| | | | - Sidney Glina
- Faculdade de Medicina do ABC, Santo André, SP, Brazil
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20
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Neurolysis of the Dorsal Nerve to the Penis to Restore Function After Trauma. Ann Plast Surg 2021; 84:307-311. [PMID: 31904648 DOI: 10.1097/sap.0000000000002144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Loss of penile sensation or development of a painful penis and erectile dysfunction can occur after injury to the dorsal branch of the pudendal nerve. Although recovery of genital sensibility has been discussed frequently in transmen, this subject has been reported rarely in cismen. The purpose of this report is to review our experience with recovery of sensation in men after decompression of the dorsal branch of the pudendal nerve after trauma. METHODS A retrospective chart review of men who have had decompression of the dorsal branch of the pudendal nerve was carried out from 2014 to 2018. Patients were included in the cohort if they had a loss of penile sensation or the development of a painful penis after trauma. Primary outcomes measured were the change in penile symptoms, including erection, ejaculation, ejaculatory pain, erogenous sensation, numbness, and penile pain. RESULTS For the 7 men included in this study, the mean follow-up time was 57 weeks (range, 28-85 weeks). Bilateral surgery was done in 71% (5/7). Of the 6 patients with loss of penile sensation, complete recovery of erogenous sensibility occurred in 5 (83%) patients, with partial relief in 1 (17%) patient. Of the 3 men who had erectile dysfunction, normal erections were restored in 2 (67%) patients. Of the 2 patients unable to ejaculate, 1 (50%) patient regained ejaculatory function. Of the 4 patients with ejaculatory pain, complete relief of pain occurred in 2 (50%) patients, with partial relief in 2 (50%) patients. Of the 6 patients with penile pain in the absence of ejaculation, complete relief of pain occurred in 3 (50%) patients, with partial relief in 3 (50%) patients. CONCLUSION Neurolysis of the dorsal nerve to the penis at the inferior pubic ramus canal can be successful in relieving pain, and restoring sensation and erectile function in men who sustained an injury along the inferior pubic ramus.
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21
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Molina-Torres G, Ochandorena-Acha M, Echazarreta-Aparicio Y, Sánchez-Labraca N, González-Sánchez M, Terradas-Monllor M, Varela-Vásquez LA, Merchán-Baeza JA, Minobes-Molina E. Is Cycling Practice Related to Men's Pelvic Floor Dysfunctions? A Hypothesis-Generating Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041923. [PMID: 33671183 PMCID: PMC7922672 DOI: 10.3390/ijerph18041923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022]
Abstract
Background: There is a lack of consensus with regards to the consequences of cycling practice on urogenital and sexual problems in men. The aim of the study was to analyse the relationship between intensity of cycling practice and urinary tract symptoms, erectile dysfunction, and urinary incontinence. Methods: Observational hypothesis-generating design. Cyclists, men, between 25 and 70 years who had been cycling for more than one year were included. During the statistical analysis, a multiple linear regression model, partial correlation and Spearman’s correlation were carried out. Results: Fifty-eight men participated in the study. Results showed that there is a correlation between years of cycling and prostate symptoms (p = 0.041), and between age and erectile dysfunction (p = 0.001). The multiple linear regression model and the partial correlation analysis showed a correlation between the years of cycling and prostate symptoms (p = 0.007 and p = 0.018). Conclusions: The results have shown that there is a slight correlation between the years of cycling and the presence of lower urinary tract symptoms, independently of the man’s age. Therefore, the results display that high-intensity cycling practice might impact negatively in some men’s pelvic floor functions. Further research is needed to analyse the impact of cycling on urogenital problems in this population group.
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Affiliation(s)
- Guadalupe Molina-Torres
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, 04120 Almeria, Spain; (G.M.-T.); (Y.E.-A.); (N.S.-L.)
| | - Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Familia, 7, 08500 Vic, Spain; (M.O.-A.); (M.T.-M.); (L.A.V.-V.); (E.M.-M.)
| | - Yune Echazarreta-Aparicio
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, 04120 Almeria, Spain; (G.M.-T.); (Y.E.-A.); (N.S.-L.)
| | - Nuria Sánchez-Labraca
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, 04120 Almeria, Spain; (G.M.-T.); (Y.E.-A.); (N.S.-L.)
| | - Manuel González-Sánchez
- Department of Psychiatry and Physiotherapy, Institute of Biomedical Research of Malaga (IBIMA), University of Malaga, 29071 Malaga, Spain;
| | - Marc Terradas-Monllor
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Familia, 7, 08500 Vic, Spain; (M.O.-A.); (M.T.-M.); (L.A.V.-V.); (E.M.-M.)
| | - Luz A. Varela-Vásquez
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Familia, 7, 08500 Vic, Spain; (M.O.-A.); (M.T.-M.); (L.A.V.-V.); (E.M.-M.)
| | - Jose Antonio Merchán-Baeza
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Familia, 7, 08500 Vic, Spain; (M.O.-A.); (M.T.-M.); (L.A.V.-V.); (E.M.-M.)
- Correspondence: ; Tel.: +34-938-886-12-22
| | - Eduard Minobes-Molina
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Familia, 7, 08500 Vic, Spain; (M.O.-A.); (M.T.-M.); (L.A.V.-V.); (E.M.-M.)
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Bury K, Leavy JE, Lan C, O'Connor A, Jancey J. A Saddle sores among female competitive cyclists: A systematic scoping review. J Sci Med Sport 2020; 24:357-367. [PMID: 33109466 DOI: 10.1016/j.jsams.2020.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Saddle sores are a prominent but an under investigated health issue among female competitive cyclists. To identify and describe existing evidence of the prevalence, prevention and treatment of saddle sores among female competitive cyclists. DESIGN Systematic scoping review and expert consultation. METHODS Primary studies and grey literature investigating saddle sores for competitive female cyclists were identified from six databases which were systematically searched (Medline; PubMed; Scopus; SPORTDiscus; Embase; Advanced Google Scholar) from 1990 onwards. An online survey was distributed to consultants in the female Australian competitive cycling community to obtain information and expert perspectives outside the published literature. RESULTS Of the 401 studies identified, 10 met the inclusion criteria - 4 were case-series, 4 were cross-sectional, and 2 were brief intervention trials. There was limited empirical evidence to determine the prevalence, and identify prevention and treatment approaches for saddle sores. Handlebar positioning relative to the saddle and reducing perineal pressure had some evidence. Saddle sore treatments appear to be limited to antibiotics and surgical intervention when they worsen or become infected. Yet, three-quarters of the consultants (n=16) indicated saddle sores were frequent among female competitive cyclists, identifying prevention and management strategies as topical creams, maintaining good hygiene, wearing appropriate clothing, leg elevation and taking time off the bike. CONCLUSIONS There is limited research investigating the prevalence, prevention and treatment of saddle sores among female competitive cyclists, although it has been described as a common occurrence by those in the cycling community. Research is required to understand its prevalence, along with trials to investigate prevention and management methods, so that evidence informed guidelines and/or protocols can be developed.
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Affiliation(s)
- Keira Bury
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Justine E Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Charlene Lan
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Amanda O'Connor
- Amanda O'Connor, National Cycling Centre Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia.
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Koupparis A, Mehmi A, Rava M, Kearley S, Aning J, Rowe E, Richardson S. Cycling and men’s health: A worldwide survey in association the Global Cycling Network. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415820915389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: This study aimed to examine the association between cycling and men’s health issues, including prostate cancer (CaP), erectile dysfunction (ED), chronic pelvic pain syndrome (CPPS) and lower urinary tract symptoms (LUTs). Methods: Information regarding CaP, ED, CPPS and LUTs were collected from 8074 male cyclists via a unique online men’s health and cycling video produced in conjunction with the Global Cycling Network (GCN) using validated questionnaires. Logistic regression analyses were used to evaluate any relationship between cycling and men’s health issues, including the effect of risk factors. Results: The GCN video received 619,105 views, and completed data were collected on 8074 male cyclists. Of these, 0.57% had a diagnosis of CaP, 14.5% described ED, 8.82 reported symptoms of CPPS and 12.5% reported LUTs. All reported symptoms were mild, and no correlation was found between cycling and CaP or ED on statistical analyses. Conclusions: This is the largest worldwide cross-section observational study on the association between cycling and men’s health. It demonstrates no negative association between cycling and CaP, ED, CPPS or LUTs. Level of evidence: Not applicable for this multicentre audit.
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Moore SL, Chebbout R, Cumberbatch M, Bondad J, Forster L, Hendry J, Lamb B, MacLennan S, Nambiar A, Shah TT, Stavrinides V, Thurtle D, Pearce I, Kasivisvanathan V. Orchidopexy for Testicular Torsion: A Systematic Review of Surgical Technique. Eur Urol Focus 2020; 7:1493-1503. [DOI: 10.1016/j.euf.2020.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 06/25/2020] [Accepted: 07/31/2020] [Indexed: 12/01/2022]
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Kim YJ, Kim DH. Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve. Yeungnam Univ J Med 2020; 38:148-151. [PMID: 32688459 PMCID: PMC8016628 DOI: 10.12701/yujm.2020.00437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022] Open
Abstract
Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock’s canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.
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Affiliation(s)
- Young Je Kim
- Department of Rehabilitation Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Du Hwan Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Piazza N, Cerri G, Breda G, Paggiaro A. The effect of a new geometric bicycle saddle on the genital-perineal vascular perfusion of female cyclists. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aoun F, Mjaess G, Daher K, Sakr G, Chemaly AK, Salameh M, Albisinni S, Absil F, Roumeguere T, Bollens R. Laparoscopic treatment of pudendal nerve and artery entrapment improves erectile dysfunction in healthy young males. Int J Impot Res 2020; 33:1-5. [PMID: 32366984 DOI: 10.1038/s41443-020-0287-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/01/2020] [Accepted: 04/09/2020] [Indexed: 12/20/2022]
Abstract
Erectile dysfunction (ED) is increasingly becoming more common in young healthy males and is attributed mainly to psychogenic causes in these patients. Recent studies have reported that ED could be secondary to pudendal nerve or artery entrapment. This perspective assessed the efficacy of laparoscopic pudendal nerve and artery decompression in young patients suffering from refractory ED, associated to a pudendal nerve entrapment syndrome. After excluding patients with psychological ED and venous leakage, five young male patients with a history of both ED and pudendal nerve entrapment syndrome diagnosed based on the Nantes criteria were recruited. Pudendal nerve and artery release was performed using a laparoscopic transperitoneal approach. International Index for Erectile Function (IIEF-5) and erectile hardness score (EHS) improved significantly in all patients, 3 months after surgery. Pudendal nerve and artery entrapment could be therefore a reversible cause of ED in young healthy males, and its treatment by laparoscopic pudendal nerve and artery decompression seems to be safe and effective.
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Affiliation(s)
- Fouad Aoun
- Urology Department, Institut Jules Bordet, Brussels, Belgium. .,Hotel-Dieu de France, Université Saint Joseph, Beirut, Lebanon. .,Mount Lebanon Hospital, Beirut, Lebanon.
| | - Georges Mjaess
- Hotel-Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Karim Daher
- Rizk Hospital (LAU Medical Center), Beirut, Lebanon
| | | | - Anthony Kallas Chemaly
- Hotel-Dieu de France, Université Saint Joseph, Beirut, Lebanon.,Mount Lebanon Hospital, Beirut, Lebanon
| | | | - Simone Albisinni
- Urology Department, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Thierry Roumeguere
- Urology Department, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Renaud Bollens
- Department of Urology, Université Nord de France, St Phillibert Hospital, GHICL, Lille, France.,Wallonie Picarde Hospital, Tournai, Belgium
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Ducharme O, Schollhammer R, Leduc J, Baubion E, Farid K, Amazan E. Lymphatic drainage abnormalities in a child presenting as an unilateral vulvar swelling: a case of 'Bicyclist's vulva'. J Eur Acad Dermatol Venereol 2019; 34:e171-e173. [PMID: 31785098 DOI: 10.1111/jdv.16117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- O Ducharme
- Department of Dermatology, CHU Martinique, Fort-De-France, Martinique
| | - R Schollhammer
- Department of Nuclear Medicine, CHU Martinique, Fort-De-France, Martinique
| | - J Leduc
- Department of Dermatology, CHU Martinique, Fort-De-France, Martinique
| | - E Baubion
- Department of Dermatology, CHU Martinique, Fort-De-France, Martinique
| | - K Farid
- Department of Nuclear Medicine, CHU Martinique, Fort-De-France, Martinique
| | - E Amazan
- Department of Dermatology, CHU Martinique, Fort-De-France, Martinique
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Panara K, Masterson JM, Savio LF, Ramasamy R. Adverse Effects of Common Sports and Recreational Activities on Male Reproduction. Eur Urol Focus 2019; 5:1146-1151. [DOI: 10.1016/j.euf.2018.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/21/2018] [Accepted: 04/20/2018] [Indexed: 01/31/2023]
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Greenberg DR, Khandwala YS, Breyer BN, Minkow R, Eisenberg ML. Genital Pain and Numbness and Female Sexual Dysfunction in Adult Bicyclists. J Sex Med 2019; 16:1381-1389. [PMID: 31402178 DOI: 10.1016/j.jsxm.2019.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/28/2019] [Accepted: 06/30/2019] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Bicycle seat pressure on the perineum may impair arousal and clitoral erection, likely contributing to genital pain and numbness experienced by female cyclists. AIM We aimed to identify the association between genital pain and numbness experienced by female cyclists and female sexual dysfunction (FSD). METHODS Female cyclists were recruited to complete an online survey using the Female Sexual Function Index (FSFI), a validated questionnaire to assess FSD. Cyclist demographics, experience, preferred riding style, use of ergonomic cycle modifications, and genital discomfort while riding were also queried. Multivariate logistic regression analysis was used to evaluate risk factors of FSD. MAIN OUTCOME MEASURES The main outcome was FSFI score, which is used to diagnose FSD when the FSFI score is <26.55. RESULTS Of the survey respondents, 178 (53.1%) completed the survey and FSFI questionnaire. Mean age was 48.1 years (±0.8 standard error [SE]), and the average riding experience was 17.1 years (±0.9 SE). Overall, 53.9% of female cyclists had FSD, 58.1% reported genital numbness, and 69.1% reported genital pain. After adjusting for age, body mass index, relationship status, smoking history, comorbidities, and average time spent cycling per week, females who reported experiencing genital numbness half the time or more were more likely to have FSD (adjusted odds ratio [aOR], 6.0; 95% CI, 1.5-23.6; P = .01), especially if localized to the clitoris (aOR, 2.5; 95% CI, 1.2-5.5; P = .02). Females that reported genital pain half the time or more while cycling also were more likely to have FSD (aOR, 3.6; 95% CI, 1.2-11.1; P = .02). Cyclists experiencing genital pain within the first hour of their ride were more likely to have FSD (aOR, 12.6; 95% CI, 2.5-63.1; P = .002). Frequency and duration of cycling were not associated with FSD. Analysis of FSFI domains found that the frequency of numbness was correlated with decreased arousal, orgasm, and satisfaction during intercourse, whereas the frequency of pain significantly reduced arousal, orgasm, and genital lubrication. CLINICAL IMPLICATIONS Female cyclists that experience numbness and/or pain have higher odds of reporting FSD. STRENGTHS & LIMITATIONS Our study includes a validated questionnaire to assess FSD and queries specific characteristics and symptoms of genital pain and genital numbness; however, the study is limited by its cross-sectional survey design. CONCLUSION This study highlights the need for cyclists to address genital pain and numbness experienced while cycling, and future studies are required to determine if alleviating these symptoms can reduce the impact of cycling on female sexual function. Greenberg GR, Khandwala YS, Breyer BN, et al. Genital Pain and Numbness and Female Sexual Dysfunction in Adult Bicyclists. J Sex Med 2019; 16:1381-1389.
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Affiliation(s)
- Daniel R Greenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
| | - Yash S Khandwala
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Benjamin N Breyer
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
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Hervás-Pérez JP, Jiménez Díaz-Benito V, Guodemar-Pérez J, Ruiz-López M, García-Fernández P, Rodríguez-López ES, Pérez-Manchón D. [The influence of physical activity as an alternative treatment to chronic prostatitis: A meta-analysis]. Rev Int Androl 2019; 18:107-116. [PMID: 30871896 DOI: 10.1016/j.androl.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/12/2018] [Accepted: 12/02/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Chronic prostatitis is one of the most common diagnoses in outpatient clinics in Urology. It is presented as a heterogeneous group of diseases, whose etiology is often unknown, showing as a common denominator a set of painful, irritative and obstructive symptoms of the genitourinary tract and perineum. OBJECTIVES A systematic review and updated meta-analysis of this pathology was performed in relation to the damages or benefits that physical activity could have in chronic prostatitis or chronic pelvic pain. METHODS The Scopus, PubMed, ScienceDirect, PEDro, The Cochrane Library, Dialnet and SciELO databases were consulted until June 2018 (the last paper used in this meta-analysis was published in March 2018). RESULTS The research team reviewed a total of 93 studies, of which 10 were selected, with a subsequent examination of their methodological quality using the PEDro scale. The comparison of the body mass index, the quality of life related to the body mass index and the correlation of the urinary incontinence were made. The overall analysis of the interventions within the urinary incontinence was significant (effect size: 0.11; 95% CI 0.038 to 0.43; P=.024). CONCLUSIONS The variability associated with experimental designs represents a heterogeneity in the effects of different programs or physical activity interventions for the treatment of chronic prostatitis. The effect sizes obtained suggest that the effectiveness of alternative treatment programs, using vehicular physical activity, may be related to the type of intervention performed.
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Affiliation(s)
- Juan Pablo Hervás-Pérez
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España.
| | - Victor Jiménez Díaz-Benito
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, España
| | - Jesús Guodemar-Pérez
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - Montserrat Ruiz-López
- Departamento de Enfermería, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - Pablo García-Fernández
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Alfonso X, Villanueva de la Cañada, Madrid, España
| | - Elena Sonsoles Rodríguez-López
- Departamento de Fisioterapia, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
| | - David Pérez-Manchón
- Departamento de Enfermería, Facultad de Educación y Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España
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Tamoli S, Mundhe N, Deshmukh D, Pande S, Kamde R, Kumbhar V, Upasani S, Mahadik S. An open-label, multi-center, prospective, interventional, clinical study to evaluate the efficacy and safety of Ayuvigo forte capsules in patients suffering from oligospermia. Pharmacognosy Res 2019. [DOI: 10.4103/pr.pr_158_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sansone A, Sansone M, Vaamonde D, Sgrò P, Salzano C, Romanelli F, Lenzi A, Di Luigi L. Sport, doping and male fertility. Reprod Biol Endocrinol 2018; 16:114. [PMID: 30415644 PMCID: PMC6231265 DOI: 10.1186/s12958-018-0435-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/24/2018] [Indexed: 11/11/2022] Open
Abstract
It is universally accepted that lifestyle interventions are the first step towards a good overall, reproductive and sexual health. Cessation of unhealthy habits, such as tobacco, alcohol and drug use, poor nutrition and sedentary behavior, is suggested in order to preserve/improve fertility in humans. However, the possible risks of physical exercise per se or sports on male fertility are less known. Being "fit" does not only improve the sense of well-being, but also has beneficial effects on general health: in fact physical exercise is by all means a low-cost, high-efficacy method for preventing or treating several conditions, ranging from purely physical (diabetes and obesity) to psychological (depression and anxiety), highly influencing male reproduction. If male sexual and reproductive health could be positively affected by a proper physical activity, inadequate bouts of strength - both excessive intensity and duration of exercise training - are more likely to have detrimental effects. In addition, the illicit use of prohibited drugs (i.e. doping) has reached pandemic proportions, and their actions, unfortunately very often underestimated by both amateur and professional athletes, are known to disrupt at different levels and throughout various mechanisms the male hypothalamic-pituitary-gonadal axis, resulting in hypogonadism and infertility.
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Affiliation(s)
- Andrea Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Massimiliano Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Diana Vaamonde
- Morphological Sciences Department, School of Medicine, Universidad de Córdoba, Cordoba, Spain
| | - Paolo Sgrò
- Department of Movement, Human and Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", Largo Lauro de Bosis 15, 00135, Rome, Italy
| | - Ciro Salzano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Naples, Italy
| | - Francesco Romanelli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luigi Di Luigi
- Department of Movement, Human and Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", Largo Lauro de Bosis 15, 00135, Rome, Italy.
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Larsen AS, Larsen FG, Sørensen FF, Hedegaard M, Støttrup N, Hansen EA, Madeleine P. The effect of saddle nose width and cutout on saddle pressure distribution and perceived discomfort in women during ergometer cycling. APPLIED ERGONOMICS 2018; 70:175-181. [PMID: 29866308 DOI: 10.1016/j.apergo.2018.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/26/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
The objectives were 1) to design and produce two novel unpadded bicycle saddles with a wide/medium width and partial nose cutout; 2) to investigate the responses on pressure distribution and perceived discomfort in female cyclists. For comparison, a standard saddle was also tested. Nineteen female cyclists pedaled on an ergometer cycle for 20 min with each saddle in a counterbalanced order. A pressure mat measured saddle interface pressure. Discomfort ratings were collected using a visual analogue scale. Total mean saddle pressure remained similar across saddles. The wide saddle increased anterior and decreased posterior mean saddle pressure as compared with the standard (p < .002) and the medium saddle (p < .001). Significantly increased ischial tuberosity discomfort was found for the novel saddles (p < .001), while crotch discomfort was not significantly different between saddles. The medium width saddle appeared to be the best compromise since increased crotch discomfort was avoided and saddle pressures were redistributed. Such design may be suggested as an alternative to traditional saddles for women reporting discomfort in the perineal region.
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Affiliation(s)
- Anna Sofie Larsen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Frederik G Larsen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Frederik F Sørensen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Mathias Hedegaard
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Nicolai Støttrup
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Ernst A Hansen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Pascal Madeleine
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark.
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Sanford T, Gadzinski AJ, Gaither T, Osterberg EC, Murphy GP, Carroll PR, Breyer BN. Effect of Oscillation on Perineal Pressure in Cyclists: Implications for Micro-Trauma. Sex Med 2018; 6:239-247. [PMID: 29936216 PMCID: PMC6085221 DOI: 10.1016/j.esxm.2018.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Genital numbness and erectile dysfunction in cyclists may result from repeated perineal impacts on the bicycle saddle (micro-trauma) that occur during routine cycling. AIM To evaluate the relationship between oscillation forces and perineal pressures among cyclists in a simulated laboratory setting. METHODS Participants were fit to a study bicycle to ensure all cyclists had the same torso angle (60 ± 1 degree) and maximum knee angle (150 ± 1 degree). A lever system was used to generate oscillation events of 3 progressively increasing magnitudes. Perineal pressure was continuously measured using a pressure sensor on the bicycle saddle. This process was carried out in each of the following conditions: (1) stationary (not pedaling) with the standard seatpost, (2) pedaling with standard seatpost, (3) stationary with seatpost shock absorber, and (4) pedaling with seatpost shock absorber. OUTCOMES We compared perineal pressure changes during oscillation events in the stationary and pedaling states, with and without the seatpost shock absorber. RESULTS A total of 39 individuals were recruited (29 men and 10 women). As the amount of oscillation increased from an average of 0.7g (acceleration due to Earth's gravity) to 1.3g, the perineal pressure increased from 10.3% over baseline to 19.4% over baseline. There was a strong linear relationship between the amount of oscillation and increase in pressure (r2 = 0.8, P < .001). A seatpost shock absorber decreased the impact of oscillation by 53% in the stationary condition. Men and women absorbed the majority of shock in areas corresponding to pelvic bony landmarks. CONCLUSION This study represents one of the first characterizations of cycling-associated perineal micro-trauma in a laboratory setting. We found a strong linear relationship between oscillation magnitude and perineal pressure during cycling, which was mitigated by a seatpost shock absorber. The use of shock absorption in bicycle design may reduce perineal micro-trauma and potentially improve cycling-associated perineal numbness and erectile dysfunction. Sanford T, Gadzinski AJ, Gaither T, et al. Effect of Oscillation on Perineal Pressure in Cyclists: Implications for Micro-Trauma. Sex Med 2018;6:239-247.
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Affiliation(s)
- Thomas Sanford
- Department of Urology, University of California San Francisco, San Francisco, CA, USA.
| | - Adam J Gadzinski
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Thomas Gaither
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - E Charles Osterberg
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Greg P Murphy
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Peter R Carroll
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
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Baradaran N, Awad M, Gaither TW, Fergus KB, Ndoye M, Cedars BE, Balakrishnan AS, Eisenberg ML, Sanford T, Breyer BN. The association of bicycle-related genital numbness and Sexual Health Inventory for Men (SHIM) score: results from a large, multinational, cross-sectional study. BJU Int 2018; 124:336-341. [DOI: 10.1111/bju.14396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Nima Baradaran
- Department of Urology; University of California San Francisco; San Francisco CA USA
| | - Mohannad Awad
- Department of Surgery; King Abdulaziz University; Rabigh Saudi Arabia
| | - Thomas W. Gaither
- Department of Urology; University of California San Francisco; San Francisco CA USA
| | | | - Medina Ndoye
- Department of Urology; University of California San Francisco; San Francisco CA USA
| | - Benjamin E. Cedars
- Department of Urology; University of California San Francisco; San Francisco CA USA
| | | | - Michael L. Eisenberg
- Department of Urology; Stanford University School of Medicine; San Francisco CA USA
| | - Tom Sanford
- Department of Urology; University of California San Francisco; San Francisco CA USA
| | - Benjamin N. Breyer
- Department of Urology; University of California San Francisco; San Francisco CA USA
- Department of Biostatistics and Epidemiology; University of California San Francisco; San Francisco CA USA
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Yuan X, Bevelaqua AC. Buttock Pain in the Athlete: the Role of Pelvic Floor Dysfunction. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2018. [DOI: 10.1007/s40141-018-0188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hwang K, Guo D. Sports-related Male Infertility. Eur Urol Focus 2018; 5:1143-1145. [PMID: 29729871 DOI: 10.1016/j.euf.2018.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/21/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
Many common sports and sports-related behaviors and practices represent potential sources of male infertility. Clinicians should be aware of these associations in the evaluation of idiopathic infertility in men.
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Affiliation(s)
- Kathleen Hwang
- Department of Surgery (Urology), Brown University, Providence, RI, USA.
| | - David Guo
- Department of Surgery (Urology), Brown University, Providence, RI, USA
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Gaither TW, Awad MA, Murphy GP, Metzler I, Sanford T, Eisenberg ML, Sutcliffe S, Osterberg EC, Breyer BN. Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study. J Sex Med 2018; 15:510-518. [DOI: 10.1016/j.jsxm.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/11/2018] [Indexed: 10/17/2022]
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Abstract
With the increasing popularity of mountain biking, also known as off-road cycling, and the riders pushing the sport into extremes, there has been a corresponding increase in injury. Almost two thirds of acute injuries involve the upper extremities, and a similar proportion of overuse injuries affect the lower extremities. Mountain biking appears to be a high-risk sport for severe spine injuries. New trends of injury patterns are observed with popularity of mountain bike trail parks and freeride cycling. Using protective gear, improving technical proficiency, and physical fitness may somewhat decrease the risk of injuries. Simple modifications in bicycle-rider interface areas and with the bicycle (bike fit) also may decrease some overuse injuries. Bike fit provides the clinician with postural correction during the sport. In this review, we also discuss the importance of race-day management strategies and monitoring the injury trends.
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Affiliation(s)
- Majid Ansari
- 1Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; and 2Department of Family Medicine, University of Colorado School of Medicine, AFW Clinic, Denver, CO
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Editorial Comment. J Urol 2018; 199:804. [DOI: 10.1016/j.juro.2017.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gulino G, Sasso F, D'Onofrio A, Palermo G, Luigi D, Sacco E, Pinto F, Bassi P. Sport, Infertility and Erectile Dysfunction. Urologia 2018. [DOI: 10.1177/039156031007700206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the last decades a growing interest has been dedicated to prevention, diagnosis and therapy of male genital pathologies, such as varicocele, infertility and erectile dysfunction in the population involved in sport activities. High incidence (up to 30%) of varicocele has been reported in a population of athletes and up to 60–80% in the subgroup of body-builders. The incidence of varicocele specifically increases with hours of training, in a linear model. Controversial data come from literature about the effects of physical activity on fertility, with prevalence of trials demonstrating worsening of seminal parameters. Furthermore, it has been demonstrated that physical stress in healthy male athletes can interfere with LH levels. Bicycling is one of the major risk factors for erectile dysfunction, with incidence of 13–24%. This is due to the prolonged compression of perineal arteries leading to reduced chronic penile perfusion. Bioengineering studies have been the basis for industry to produce specifically shaped saddles that significantly reduce and minimize compressive effects. Finally, high frequency of lower urinary tract symptoms (LUTS) in cyclists has been related to increased incidence of erectile dysfunction in comparison with normal population.
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Affiliation(s)
- G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Sasso
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Onofrio
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Palermo
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - Di Luigi
- Servizio di Endocrinologia, Facoltà Scienze Motorie, ISUM, Roma
| | - E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Sacco E, Marangi F, Pinto F, D'Addessi A, Racioppi M, Gulino G, Volpe A, Gardi M, Bassi P. Sports and Genitourinary Traumas. Urologia 2018. [DOI: 10.1177/039156031007700208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Statistical data referring to sports-related traumas of the urinary tract are quite scarce; nevertheless, it is possible to draw general data on the relationship between sports and urological traumas. Methods Literature review of peer-reviewed articles published by May 2009. Results Urological traumas account for about 10% of all traumas, and about 13% of them is sports-related. Genitourinary traumas are among the most common cause of abdominal injuries in sports. Blunt injuries are more common than penetrating ones and renal injuries are by far the most common, followed by testicular injuries; ureters, bladder and penis injuries are much more infrequent. Considering chronic microtraumas, injuries of bulbar urethra are also common in sports that involve riding. Overall, the incidence of genitourinary trauma due to sports is low. Renal traumas in sports injuries usually consist of grade 1–11 lesions and usually do not require surgical treatment. Cycling is the sporting activity most commonly associated with genitourinary injuries, followed by winter sports, horse riding and contact/collision sports. Literature data suggest that significant injuries are rare also in athletes with only one testicle or kidney. General preventive measures against sport-related injuries, along with the use of protective cups for male external genitalia, are generally sufficient to reduce the incidence of urogenital trauma. Conclusions Overall, studies show that urogenital injuries are uncommon in team and individual sports, and that most of them are low-grade injuries. Participation in sports that involve the potential for contact or collision needs to be carefully assessed in the athletes with only one testicle or kidney, even though urogenital injuries should not preclude sports participation to an appropriately informed and counseled patient. Further research is needed to acquire more knowledge on genitourinary injuries according to age, sports type and technical skill.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Addessi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Sacco E, Totaro A, Marangi F, Pinto F, Racioppi M, Gulino G, Volpe A, Gardi M, Bassi P. Prostatitis Syndromes and Sporting Activities. Urologia 2018. [DOI: 10.1177/039156031007700209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Prostatitis-like syndromes are high prevalent health problems and frequently considered by patients and physicians as strictly correlated to sports causing perineal compression. These syndromes and their relationships with sporting activities have been discussed in this report. Methods We reviewed peer-reviewed scientific articles published by May 2009 and searched according to the following term selection: prostatitis, pudendal nerve, sport, cycling. Results Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major healthcare burden heavily affecting patients’ Quality of Life. No clear evidence of any direct etiologic relationship has been found in literature between prostatitis, either bacterial or non-bacterial, and sports activities. On the other hand, some types of sport causing perineal compression, such as cycling, can exacerbate symptoms of acute and chronic prostatitis; a temporary sport discontinuation is justified in these patients. CP/CPPS may be often caused by pudendal nerve entrapment (PNE). Prostatitis-like urogenital neuropathic pain together with voiding and sexual dysfunctions are the hallmark of PNE. A common feature is that flexion activities of the hip, such as climbing, squatting, cycling provoke or worsen urogenital pain or pelvic pain. Many of the patients with PNE are cyclists, played American football, lifted weights, or wrestled as teenagers and young adults. PNE represents the most common bicycling associated urogenital problems. Conclusions Overall, studies show that no causal relationship has been demonstrated between prostatitis and sporting activities. Conversely, urologists should be aware that sports involving vigorous hip flexion activities or prolonged perineal compression are a potential and not an infrequent cause of uroand rological symptoms caused by pudendal nerve entrapment.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Totaro
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Abstract
The purpose of this clinical commentary is to review the anatomy, etiology, evaluation, and treatment techniques for nerve entrapments of the hip region. Nerve entrapment can occur around musculotendinous, osseous, and ligamentous structures because of the potential for increased strain and compression on the peripheral nerve at those sites. The sequela of localized trauma may also result in nerve entrapment if normal nerve gliding is prevented. Nerve entrapment can be difficult to diagnose because patient complaints may be similar to and coexist with other musculoskeletal conditions in the hip and pelvic region. However, a detailed description of symptom location and findings from a comprehensive physical examination can be used to determine if an entrapment has occurred, and if so where. The sciatic, pudendal, obturator, femoral, and lateral femoral cutaneous are nerves that can be entrapped and serve a source of hip pain in the athletic population. Manual therapy, stretching and strengthening exercises, aerobic conditioning, and cognitive-behavioral education are potential interventions. When conservative treatment is ineffective at relieving symptoms surgical treatment with neurolysis or neurectomy may be considered. Level of Evidence 5.
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Abstract
The relationships between sport and sexuality in males are of great social and clinical interest, because of sports and motor activities that highly promote social and sexual relationships. Even if few literature exist, two main questions should be taken into account: whether and how physical exercise and sport positively or negatively influence sexual health and behavior and/or whether and how sexual behavior may affect a sub-sequent sport performance. Physical exercise and sport per se can influence, positively or negatively, the hypothalamic-pituitary-testicular axis function and, consequently, the individual's reproductive and/or sexual health. This depends on individual factors such as genetic and epigenetic ones and on different variables involved in the practice of sport activities (type of sport, intensity and duration of training, doping and drug use and abuse, nutrition, supplements, psychological stress, allostatic load, etc.). If well conducted, motor and sport activities could have beneficial effects on sexual health in males. Among different lifestyle changes, influencing sexual health, regular physical activity is fundamental to antagonize the onset of erectile dysfunction (ED). However, competitive sport can lead both reproductive and/or sexual tract damages and dysfunctions, transient (genital pain, hypoesthesia of the genitalia, hypogonadism, DE, altered sexual drive, etc.) or permanent (hypogonadism, DE, etc.), by acting directly (traumas of the external genitalia, saddle-related disorders in cyclists, etc.) or indirectly (exercise-related hypogonadism, drug abuse, doping, stress, etc.). Sexual activities shortly performed before a sport competition could differently influence sport performance. Due to the few existing data, it is advisable to avoid an absolute pre-competition sexual abstinence.
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Affiliation(s)
- P Sgrò
- Unit of Endocrinology, Section of Health Sciences, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - L Di Luigi
- Unit of Endocrinology, Section of Health Sciences, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
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Viers BR, Pagliara TJ, Rew CA, Folgosa Cooley L, Shiang CY, Scott JM, Morey AF. Characteristics of Idiopathic Urethral Strictures: A Link to Remote Perineal Trauma? Urology 2017; 110:228-233. [PMID: 28755966 DOI: 10.1016/j.urology.2017.07.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize the physical features and reconstructive outcomes of a series of idiopathic urethral strictures (IUS) in an effort to elucidate the nature of this common yet poorly understood entity. PATIENTS AND METHODS We retrospectively reviewed our urethroplasty database to identify men undergoing initial urethral reconstruction from 2007 to 2014 at 1 of 3 hospitals (N = 514). Patients were stratified by stricture etiology, including IUS, acute trauma, iatrogenic, hypospadias, balanitis xerotica obliterans, and radiation. IUS that had a known history of subacute or repetitive blunt force to the perineum (horseback riding, avid cycling, motocross, etc.) were subclassified as subacute or repetitive perineal trauma (SRPT). RESULTS Among 466 men undergoing initial reconstruction with available data, 215 (46%) were IUS cases. The median delay between IUS diagnosis and urethroplasty was 5.2 years, during which time men underwent a median of 2 endoscopic treatments. A total of 51 (24%) IUS cases recalled a distinct history of SRPT. Men with SRPT were slightly younger (median 43 vs 48 years, P = .01) but were remarkably similar in terms of urethral stricture length (2 vs 2 cm, P = .15), location (bulbar 96% vs 89%, P = .41), and treatment success (92% vs 88%; P = .61). Bulbar (-)SRPT and (+)SRPT IUS had similar clinical and morphometric features as those with known acute bulbar trauma with excellent 24-month stricture recurrence-free survival rates (93% vs 92% vs 97%, P = .19). CONCLUSION IUS have clinical features suggesting that many may be related to unrecognized or repetitive perineal trauma. Although treatment tends to be delayed, IUS have excellent urethroplasty success because most are short bulbar strictures amenable to anastomotic urethroplasty.
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Affiliation(s)
- Boyd R Viers
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Travis J Pagliara
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Charles A Rew
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Christine Y Shiang
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jeremy M Scott
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Allen F Morey
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
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Wadhwa V, Hamid AS, Kumar Y, Scott KM, Chhabra A. Pudendal nerve and branch neuropathy: magnetic resonance neurography evaluation. Acta Radiol 2017; 58:726-733. [PMID: 27664277 DOI: 10.1177/0284185116668213] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pudendal neuralgia is being increasingly recognized as a cause of chronic pelvic pain, which may be related to nerve injury or entrapment. Due to its complex anatomy and branching patterns, the pudendal nerve abnormalities are challenging to illustrate. High resolution 3 T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathies. In this article, the authors discuss the normal pudendal nerve anatomy and its variations, technical considerations of pudendal nerve imaging, and highlight the normal and abnormal appearances of the pudendal nerve and its branches with illustrative case examples.
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Affiliation(s)
- Vibhor Wadhwa
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Aws S Hamid
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yogesh Kumar
- Department of Radiology, Yale New Haven Health System at Bridgeport Hospital, Bridgeport, Connecticut, USA
| | - Kelly M Scott
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Avneesh Chhabra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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