Friday Weird Science: Watch out, Cyclists, the Priapism could get you

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.
ResearchBlogging.org De Rose, et al. “Aterial priapism and cycling: a new worrisome reality?” Urology, 2001.
lance-armstrong-bike.jpg
(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?)


Teddy_Bear.jpg
(Hee hee. Gotcha!)
Anyway.
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.
Behold! Priapus
VetiiPriapus.jpg
(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:
kickedinthenuts.jpg
But there are other ways to achieve blunt trauma to this area. And one of those ways involves perching your penis on this:
Racingcycleseat.jpg
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.
cavernosa.gif
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

26 Responses

  1. Fortunately, recumbent bicycles allow you to go fast comfortably. 🙂

  2. Sci, do you have some sort of supernatural power that helps you find freaky images? Seriously, a teddy bear stripping out of his fur? A cyclist who, judging by the tan, normally wears clothes but decided to go nude the one day it snowed?!? AND who is very conveniently doing a perfect demonstration of the very low, contorted posture which puts one at most risk for these injuries.

  3. This is precisely why I prefer to have a very soft seat and sit upright on my bike. Sure, it may still be somewhat dangerous. But at least I’m not continually mashing my junk.

  4. Jacob: aha. Ok, Google “Lance Armstrong bike” and you will get that pic in the top ten. Google “Teddy Bear”, and that is the FIRST pic that comes up. My google-fu is not that strong, really it’s ok. And I also agree that I am a little ashamed of Lance’s farmer tan…

  5. Jacob: aha. Ok, Google “Lance Armstrong bike” and you will get that pic in the top ten. Google “Teddy Bear”, and that is the FIRST pic that comes up. My google-fu is not that strong, really it’s ok. And I also agree that I am a little ashamed of Lance’s farmer tan…

  6. I bike a lot, and have lots of friends who do and have never heard of this problem. So I don’t think this happens a lot.

  7. Just to clarify, the sole study linking cycling and impotence is massively flawed. The control group was a group of swimmers (to account for fitness). The problem was the control group’s mean age was ~31, whereas the cycling group’s mean age was ~42. Age effects completely unaccounted for…
    Also, Specialized, Selle Italia, and Selle San Marco all make excellent saddles with anatomical cutouts, to protect your junk.

  8. Wilfred and Dr. John: I guess I didn’t emphasize enough, but the priapism thing is VERY rare. It’s more common in those who are cylists, but still VERY rare. Far more common are injuries associated with things like not wearing a helmet.
    And I want to see hilarious anatomically correct cutouts for your junk on bicycle saddles.

  9. Kindly quit dissing bicycle safety,
    http://www.kenkifer.com/bikepages/health/risks.htm
    or at least stop pretending to pay attention to data if you do.

  10. Gregory, I am not dissing bicycle safety at all. I noted that each sport has its dangers. While cycling is very often a safe form of exercise (I know many cyclists, most of whom are very badass), there are also precautions that need to be taken, but that is the same whether you are biking, running, swimming, or even just driving a car. I don’t believe I included any statistics or anything else ranking the safety vs dangers of bicycle riding. Rather, I was highlighting a rare medical problem which can arise through blunt trauma, incidences of which have been known to occur to bicyclists. Would you react so negatively had I instead talking about something like shin splints, something which is relatively common in runners, and stated it as a possible risk of long distance running?

  11. Far more common are injuries associated with things like not wearing a helmet.

    You really ought to do a review of the literature on bicycle helmets and head/neck injury. Being a neuroblogger, I suspect you will find it fascinating, and I know your readers will.

  12. Gregory Marton you really got an atttitude and insulted thinking Sci was “dissing bicycle safety”(your words)? You should really think about killing yourself. No really, think bout it.

  13. “And I want to see hilarious anatomically correct cutouts for your junk on bicycle saddles.”
    Actually, the saddle pictured in your post has such a cutout: it’s the longitudinal depression (the hole, presumably is for ventilation or styling. They’re claimed to avoid pressure on the perineal (sp?) nerve which can cause numbness (insert joke here) and, sometimes, permanent damage. Some have just holes; others just valleys. Still others, nada.
    My saddle has no such cutout and I have no problem.

  14. “And I want to see hilarious anatomically correct cutouts for your junk on bicycle saddles.”
    Actually, the saddle pictured in your post has such a cutout: it’s the longitudinal depression (the hole, presumably is for ventilation or styling. They’re claimed to avoid pressure on the perineal (sp?) nerve which can cause numbness (insert joke here) and, sometimes, permanent damage. Some have just holes; others just valleys. Still others, nada.
    My saddle has no such cutout and I have no problem.

  15. LOL – roflmao!!!111one
    Man, that is like the funniest post I have read all YEAR!!! Love the story of Priapus, I dig Greek Myths and I totally haven’t heard that one before. Way to curse a guy! I knew the choice for the golden apple started the Trojan War, but this I didn’t know! LOVES IT!!!
    Totally linking to this post from my blog.🙂 Sci, you rock.

  16. bcoppola: REALLY?! Dang. That is not half as hilarious as I thought it would be. I was really hoping for something actually shaped like a guy’s junk.
    Captain Skellett: LOLs. Yeah, I know that’s how Hera punished Aphrodite for being hot after Paris chose her for the apple (because the Trojan War wasn’t enough). And as it is, THAT’S her revenge? “I hate you, and therefore your KID will have a HUGE PENIS.” That was…effective.

  17. bcoppola: REALLY?! Dang. That is not half as hilarious as I thought it would be. I was really hoping for something actually shaped like a guy’s junk.
    Captain Skellett: LOLs. Yeah, I know that’s how Hera punished Aphrodite for being hot after Paris chose her for the apple (because the Trojan War wasn’t enough). And as it is, THAT’S her revenge? “I hate you, and therefore your KID will have a HUGE PENIS.” That was…effective.

  18. Sci: I reckon, I bet NOBODY messes with Hera now JUST IN CASE they are cursed with a gigantic trouser snake.

  19. Truly, this is why my chair in front of my multiple monitors does not resemble a bicycle seat.

  20. Truly, this is why my chair in front of my multiple monitors does not resemble a bicycle seat.

  21. “I was really hoping for something actually shaped like a guy’s junk.”
    You have a dirty mind.🙂
    I think for us cyclists, saddles are roughly analogous to a runner’s shoes. It takes some trial and error to find comfortable ones. Then we have to fiddle with the position: height, fore/aft position, and angle. Do runners have to fiddle with just the right lace or Velcro strap tightness?
    It’s counter-intuitive, but those uncomfortable looking narrow & hard saddles are actually the most comfortable for road bikes (with the drop bars and skinny tires). Too wide a saddle causes chafing on the inner thighs. Too much padding often grows uncomfortable over time. Even without the extreme position shown in the picture of Lance Armstrong, your weight is not all on your rear but balanced between the handlebars and seat. Most riders, most of the time, ride “on the hoods”, i.e., hands resting on the brake lever housing. Or slightly behind. And us recreational riders often have the bars set higher than racers would.
    Riding with your hands “in the drops” as shown is mainly for speed and lowering wind resistance, as when fighting a headwind.
    More than you wanted to know, eh?
    Since were comparing endurance sports, an old joke. Q) What’s a triathlete? A) A person who’s not very good in three sports.

  22. bcoppola: People like to talk about running being the simplest form of exercise (all you need are shoes!), but we do indeed have to mess with straps and stuff. Not to mention that now the running shoe industry has become worth over $100 a pair plus a fitting from a specialist. For those of us who go through several pairs a year (you’re suppose to change shoes every 500 miles), this understandably gets a little expensive.
    And you wanna talk CHAFING?! I’ll see your chafing.🙂 Men in running have to put bandaids over their nipples so they don’t get bloody. We also have this lovely thing called “body glide”. You’d think you wouldn’t get a lot of chafing since many runners are such tiny things, but ANYTHING will chafe after 13 miles or more.
    I’ve now heard from several places (one of them being DrJohn in the comments above) that the best way to run is as close to barefoot as possible and that this is the best for not getting injured, but I am as yet very concerned about the transition from a support shoe to basically nothing at all.
    Really, the way you’re talking about saddle balance sounds a lot like running form, which actually takes some work for those who want to run in the big leagues (not little Sci).

  23. bcoppola: People like to talk about running being the simplest form of exercise (all you need are shoes!), but we do indeed have to mess with straps and stuff. Not to mention that now the running shoe industry has become worth over $100 a pair plus a fitting from a specialist. For those of us who go through several pairs a year (you’re suppose to change shoes every 500 miles), this understandably gets a little expensive.
    And you wanna talk CHAFING?! I’ll see your chafing.🙂 Men in running have to put bandaids over their nipples so they don’t get bloody. We also have this lovely thing called “body glide”. You’d think you wouldn’t get a lot of chafing since many runners are such tiny things, but ANYTHING will chafe after 13 miles or more.
    I’ve now heard from several places (one of them being DrJohn in the comments above) that the best way to run is as close to barefoot as possible and that this is the best for not getting injured, but I am as yet very concerned about the transition from a support shoe to basically nothing at all.
    Really, the way you’re talking about saddle balance sounds a lot like running form, which actually takes some work for those who want to run in the big leagues (not little Sci).

  24. I must admit, I did see a rather humorous health alert when looking at the CDC/NIOSH website for occupational exposures to some of the reproductive toxins my lab uses. They actually have AN. ENTIRE. PAGE. devoted to this very serious health issue.
    http://www.cdc.gov/niosh/topics/bike/
    P.S. Lance Armstrong nekkid= win

  25. Test as wide a range of saddles as possible and seek advice on fit and position on your bike.
    The SMP4Bike range at http://www.SMPSaddle.co.uk is specifically designed to minimise damage to these delicate areas

  26. You really ought to do a review of the literature on bicycle helmets and head/neck injury. Being a neuroblogger, I suspect you will find it fascinating, and I know your readers will.
    HAHAHA, you are such a colossal troll…..you trying to get a rec.bicycles.* tired old flamewar started up in this joint?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: