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Abstract
Bicycle riding is one of the most popular means of transportation, recreation, fitness
and sports among millions of people of all ages who ride on road and off road, using
a variety of bicycle types. It is also a readily available form of aerobic non-impact
exercise with established cardiovascular beneficial effects. Bicycles are also a common
source of significant injuries. This review focuses upon the specific bicycling related
overuse injuries affecting the genitourinary tract.
MEDLINE search of the literature on bicycling and genitourinary disorders was performed
using multiple subject headings and additional keywords. The search yielded overall
62 pertinent articles. We focused primarily on the most prevalent related disorders
such as pudendal nerve entrapment, erectile dysfunction and infertility. The potential
effect of bicycling on serum PSA level was also discussed in depth in view of its
recognized clinical importance. Infrequent disorders, which were reported sporadically,
were still addressed, despite their rarity, for the comprehensiveness of this review.
The reported incidence of bicycling related urogenital symptoms varies considerably.
The most common bicycling associated urogenital problems are nerve entrapment syndromes
presenting as genitalia numbness, which is reported in 50-91% of the cyclists, followed
by erectile dysfunction reported in 13-24%. Other less common symptoms include priapism,
penile thrombosis, infertility, hematuria, torsion of spermatic cord, prostatitis,
perineal nodular induration and elevated serum PSA, which are reported only sporadically.
Urologists should be aware that bicycling is a potential and not an infrequent cause
of a variety of urological and andrological disorders caused by overuse injuries affecting
the genitourinary system.