As some of you may know, Sci is a runner. Sci is not a cyclist. She tried. She did. It just…it hurts your BUTT!! Seriously. Nice to go fast, but… Also, Sci hears a little about runners getting hit by cars, but she hears a LOT about cyclists getting hit. Not very encouraging.
And here’s another thing that might make you think twice about entering the Tour Du France: Priapism.
De Rose, et al. “Aterial priapism and cycling: a new worrisome reality?” Urology, 2001.
(In Sci’s opinion, the best thing about cycling. Ever.)
(Photos for Friday Weird Science are, as usual, probably NSFW. And I don’t want to hear whining about how I didn’t put that in the title! You’re reading about PRIAPISM, people! What did you think there would be, pics of Teddy Bears?)
(Hee hee. Gotcha!)
Some of you may recall a previous Friday Weird Science wherein I discussed priapism, in particular the kind known as veno-occlusive priapism. This article concerns the OTHER kind of priapism: arterial, which is by far less common.
So what IS priapism? Priapism is the clinical name for a sustained erection lasting more than four hours. It is named after the god Priapus, who I’ve mentioned before, and who was the Roman god protecting male genitalia (duh), livestock, and fruit plants. The permanent erection was apparently a tribute to his lustful nature (and something for poor human men to feel really inadequate about), and due to a curse put upon him while in Aphrodite’s womb because of something Paris had done to Hera. Because Roman gods are NO good at extracting vengeance.
(He is, indeed, using a scale to help hold up his junk. From a mural in the ruins of Pompeii.)
So there are two main kinds of priapism. The first, as discussed in my previous post on the topic, is veno-occulsive priapism, in which the blood outflow of the penis is restricted for some reason. This can cause a seriously painful erection and can eventually cause infection of the penis with gangrene. Not pleasant.
The second kind of priapism is less well-known, and is arterial priapism. Rather than being a case where the outflow of the penis is blocked, this is a case where the blood inflow to the corpus cavernosa of the penis just won’t stop. This kind of priapism is rare, but luckily painless. Unluckily, this means that people will take a LONG time to see their doctor.
So how does one GET arterial priapism? Usually it’s the result of severe blunt trauma. And how exactly does one get trauma of this kind? Well, Sci can think of one way:
But there are other ways to achieve blunt trauma to this area. And one of those ways involves perching your penis on this:
So how do you get unregulated inflow to the penis? Usually this a result of a fistula. A fistula is an abnormal connection of blood vessels going somewhere they are not supposed to be. In this case, blood flows directly in to the corpus cavernosa, the open areas in the penis used to achieve erection.
Because the connection is abnormal, the veins which would normally control the outflow remain unstimulated, and so blood can continue to flow in, while also flowing out, resulting in a half-erect penis that just…stays. And stays. And STAYS.
This paper covers two case studies, both of whom were cyclists, both of whom sustained a severe blunt trauma to the penis while cycling (in these cases it wasn’t on the seat, but on the top tube of the bike, though injuries on the seat have also been reported), and both of whom ended up with erections lasting in excess of a MONTH, after which they finally went to see the doctor. I seriously hope both these poor guys worked from home. One had an erection lasting 45 days, and the other waited 60 days to see the doctor, and continued to have sex, though with difficulty, twice a week until he went to the doctor.
Luckily for everyone involved, the erections were partial, not painful (one guy even biked another 6k after getting the injury), and relatively easy to fix. You remove the fistula, and normal blood flow is restored. This often isn’t as easy as it sounds, but if it’s caught early and the problem doesn’t get worse (as in, you don’t keep cycling in the hope of just working it off), minor surgery can resolve the problem. And, unlike the venous occlusion kind of priapism, most people with arterial priapism appear to recover full sexual function in about three weeks after the erection is taken care of.
Unfortunately, this isn’t the only thing that can occur with cycling. Cyclists can also develop scrotal anesthesia, numbness of the penile shaft, urethritis, prostatitis, and impotence, among other things. Really, though, every sport has its dangers. Runners get knee, back, foot, and shin problems (among other things). So we all probably have it about the same. Still, this possibility for “blunt trauma” is something to think about when getting on your bike.
De Rose, A. (2001). Arterial priapism and cycling: a new worrisome reality? Urology, 58 (3) DOI: 10.1016/S0090-4295(01)01163-3