Cutting off the nose to save the penis.

INTRODUCTION: The average bicycle police officer spends 24 hours a week on his bicycle and previous studies have shown riding a bicycle with a traditional (nosed) saddle has been associated with urogenital paresthesia and sexual dysfunction.

AIM: The objective of this study was to assess the effectiveness of the no-nose bicycle saddle as an ergonomic intervention and their acceptance among male bicycle police officers.

METHODS: Bicycle police officers from five U.S. metropolitan areas were recruited for this study. Officers completed: (i) the International Index of Erectile Function Questionnaire (IIEF); (ii) computerized pressure measurements at the points of contact on the bicycle; the handlebars, the pedals, and the saddle; (iii) one night of nocturnal Rigiscan assessment; (iv) penile vibrotactile sensitivity threshold assessed by computerized biothesiometery. Officers selected a no-nose saddle for their bicycles and were asked to use the intervention saddle exclusively for 6 months, at which point they were retested.

MAIN OUTCOME MEASURES: Perineal pressure, urogenital numbness, penile vibrotactile sensitivity threshold, erectile function as measure by International Index of Erectile Function Questionnaire (IIEF) and Rigiscan.

RESULTS: After 6 months, 90 men were reassessed. Only three men had returned to a traditional saddle. The results are presented for those who used the no-nose saddle continuously for 6 months. There was a 66% reduction in saddle contact pressure in the perineal region (P < 0.001). There was a significant improvement in penis tactile sensation (P = 0.015). There was a significant improvement in erectile function assessed by IIEF (P = 0.015). There were no changes noted in the Rigiscan measures. The number of men indicating they had not experienced urogential paresthesia while cycling for the preceding 6 months, rose from 27% to 82% using no-nose saddles.

CONCLUSIONS: (i) With few exceptions, bicycle police officers were able to effectively use no-nose saddles in their police work. (ii) Use of no-nose saddles reduced most perineal pressure. (iii) Penile health improved after 6 month using no-nose saddles as measured by biothesiometry and IIEF. There was no improvement in Rigiscan(R) measure after 6 months of using no nose saddles, suggesting that a longer recovery time may be needed..