Bicycle Seat Neuropathy Clinical Presentation

Updated: Apr 26, 2021
  • Author: John M Martinez, MD; Chief Editor: Craig C Young, MD  more...
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Presentation

History

A recreational or elite cyclist who complains of numbness or impotence after cycling is the typical presentation of bicycle seat neuropathy. [22, 23, 24, 25] The amount of time the athlete spent cycling before the onset of symptoms is variable; however, studies have focused upon longer distance, multiday rides. Use of a stationary bicycle has also been reported as a cause of bicycle seat neuropathy.

Ask pertinent questions while obtaining the history to attempt to elicit other causes of neuropathy or impotence, such as a history of diabetes; metabolic disorders; endocrine or vascular disease; perineal trauma; or testicular, prostate, or intra-abdominal cancers.

Ask questions regarding the timing, duration, and location of the symptoms. Also inquire about the extent of the symptoms; some cyclists report mild numbness and some report more severe symptoms such as impotence or urinary incontinence.

Ask about the length and duration of rides. Also ask about any recent increase in training volume or any changes in bicycles, bicycle setup, or bicycle position.

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Physical Examination

The physical examination should focus on the urogenital and neurologic systems. A rectal examination may be indicated. The focus of the examination should be to exclude other diagnoses that may require different treatment and management.

The urogenital examination should include examination and palpation of the penis, testicles (in males), and perineal area.

Neurologic examination should include testing of motor and sensory function of the same regions.

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