title: Cutting off the nose to save the penis.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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..
authors.affiliation: Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA. sms4@cdc.gov
authors.forename: Steven M
authors.initials: SM
authors.lastname: Schrader
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Breitenstein
authors.forename: Brian D
authors.initials: BD
authors.lastname: Lowe
mesh_terms: D000328:Adult; D001642:Bicycling; D004867:Equipment Design; D007172:Erectile Dysfunction / Q000209:etiology* / Q000517:prevention & control; D006804:Ergonomics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000209:etiology* / Q000517:prevention & control; D010292:Paresthesia / Q000209:etiology / Q000517:prevention & control; D010502:Perineum; D011312:Pressure / Q000009:adverse effects