Department of Medical Biochemistry, Wroclaw Medical University, ul. Chalubińskiego 10, 50-368, Wroclaw, Poland.
Department of Microbiology, Wroclaw Medical University, ul. Chalubińskiego 4, 50-368, Wroclaw, Poland.
Sports Med. 2021 Feb;51(2):275-287. doi: 10.1007/s40279-020-01363-z.
Perineal pressure associated with bicycle riding is the cause of several genitourinary pathologies, most notably Alcock's syndrome and subsequent perineal numbness. The possible link between cycling-induced perineal numbness and erectile dysfunction makes the development of strategies for perineal protection in bicycle users critical.
To assess the effectiveness of strategies for reducing the impact of cycling on the perineum in healthy males.
We have conducted a systematic review and a meta-analysis of studies examining various means of reducing the impact of cycling on the perineum under the PRISMA guidelines.
Out of 2217 screened studies, 22 met our inclusion criteria, and 6 qualified for meta-analysis. The strategies included various designs of saddles, changes in the cycling position, seat shock absorber, shorts with different padding, using the recumbent bike. Using the no-nose saddle and recumbent bike resulted in a significant reduction of perineal pressure and higher penile oxygen pressure compared with a standard saddle. Indirect evidence supports the protective effect of standing on the pedals every few minutes during cycling. More evidence is needed to support-or dismiss-other strategies.
Current evidence supports the use of no-nose saddles as a mean to reduce the negative impact of cycling on the perineum in healthy males at the cost of worse stability and increase of posterior seat pressure. Standing on the pedals every ten minutes might be an effective and potentially widely applicable strategy. The use of a recumbent bike appears to protect the perineum, but several concerns prevent its widespread use.
与骑自行车相关的会阴压力是几种泌尿生殖系统疾病的原因，最著名的是 Alcock 综合征和随后的会阴麻木。骑自行车引起的会阴麻木与勃起功能障碍之间的可能联系使得为自行车使用者开发会阴保护策略变得至关重要。
评估各种减少健康男性会阴受到自行车影响的策略的有效性。
我们根据 PRISMA 指南对研究各种减少会阴在骑自行车时所受影响的方法进行了系统评价和荟萃分析。
在 2217 项筛选研究中，有 22 项符合纳入标准，其中 6 项符合荟萃分析标准。这些策略包括各种鞍座设计、改变骑行姿势、座垫减震器、不同衬垫的短裤、使用卧式自行车。与标准鞍座相比，使用无鼻鞍座和卧式自行车可显著降低会阴压力并提高阴茎氧压。间接证据支持在骑行过程中每隔几分钟站在踏板上的保护作用。需要更多的证据来支持或否定其他策略。
目前的证据支持使用无鼻鞍座来降低健康男性会阴在骑自行车时的负面影响，但这会以牺牲鞍座稳定性和增加座垫后部压力为代价。每隔十分钟站在踏板上可能是一种有效且具有广泛应用潜力的策略。使用卧式自行车似乎可以保护会阴，但存在一些问题使其无法广泛使用。
