1. PERINEAL ZONE

TINGLING - due to the reduction in blood flow which is a consequence of prolonged local circulatory duct compression.

CHRONIC PAIN - found in between 50% and 91% of the cyclists considered; it is associated with genital-perinea desensitization and consequent moderate to severe erectile dysfunction in 13% to 24% of cases.

INJURIES - constant and prolonged contact between the saddle and perineal region can cause various types of injuries including calluses, ulcers, skin irritations or boils with folliculitis.

The most typical perineal nodular lesion is the so-called ‘biker’s nodule’ or the ‘third testicle’. Usually this nodule looks like an elastic-callus a few centimeters long, covered in skin. Surgical removal is normally indicated as primary therapy.

2. BLADDER AND KIDNEYS

HAEMATURIA - this consists of blood in the urine. Haematuria of exertion or traumatic origin, due to repeated micro-traumas to the bladder and kidneys, is directly proportionate to the duration of physical activity.

3. PENIS

PRIAPISM - due to a more copious and abnormal blood flow into the corpora cavernosa of the penis and consists of lasting painful erection. It is consequent to vascular trauma with the formation of arterial-venous fistula.

4.TESTICLES

PSA SERUM VALUES - after cycling, probably caused by compression of the saddle on the perineum region and thus also on the prostate gland. Cyclists with prostate cancer and those with PSA serum levels over the norm, especially over the age 50, should be informed of this possible effect.

INFERTILITY - prolonged physical activity causes an increase in scrotal temperature which damages sperm generation and changes the hormonal axis of the hypothalamus-hypophysis-testicular axis.

TESTICULAR TUMOUR - significant increase in the risk of testicular seminoma in cyclists probably connected with repeated and frequent scrotal traumas; however other researchers, concerning this same question, prefer to emphasize how physical activity is a protective factor with regards to neoplasias and that this, to a certain extent, balances out the greater incidence of neoplasm in cyclists.

TORSION OF THE SPERMATIC CORD - association of this event with cycling is still controversial and debatable; the cause of torsion may be linked to an endoscrotal movement of the testicles while pedalling, accompanied by a vigorous contraction of the cremaster muscles.

5. FEMALE BODY

In the female body, from an anatomical standpoint, the neurovascular structures compressed by the saddle are the same as those in the male body. Thus women also suffer from problems and dysfunctions linked to cycling. The main and most frequent ones are anorgasmia, ulcerations and lymphoedema of the labia majora, urination difficulties, chronic perineal pain and haematuria.

Abstract below from "The Journal of Sexual Medicine"

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