Cycling and the prostate and testicles

"Sport is health" – as we all know, proverbs don't always reflect reality, which is especially true in the case of cycling. However, you don't need to resort to accidents to begin considering the negative impact of our passion on health. A particularly frequently discussed topic is the impact of cycling on the prostate, and secondarily on the testicles. Many myths and inaccuracies have arisen around this topic, so to clarify them, we decided to seek expert help.

What does the doctor say?

Dr. Roman Sosnowski , MD, a urologist from the Urinary Tract Cancer Clinic at the Oncology Center in Warsaw (he also sees patients at the Mazovia Hospital www.szpitalmazovia.pl and the Onkolmed Clinic www.onkolmed.pl), agreed to talk to us. There is no doubt that regular aerobic exercise, including cycling, is healthy, but can spending long hours in the saddle have a negative impact on men's testicles and other important organs? There is growing evidence in the medical literature that regular physical activity and maintaining a healthy body weight (avoiding overweight and obesity) are important factors in the development and progression of cancers, including those of the genitourinary system. According to the guidelines of many scientific organizations, participating in various types of sports at least three times a week for 30 minutes is essential. Cycling may be one such activity. However, to date, no correlation has been found between cycling, even with narrow, hard saddles, and the development of genitourinary cancers, including testicular cancer. The public disclosure of testicular cancer by famous cyclists such as Ivan Basso and Lance Armstrong is not an example of a cause-and-effect relationship, but merely a sign of great courage and a desire to build health awareness (there is no evidence of an increased incidence of testicular cancer in cyclists!). This approach has also served as an example for testicular cancer patients that they can overcome the disease and even win cycling races. Anyone who has ever embarked on a multi-hour workout, especially in tighter underwear, knows the feeling of organs going numb. Does this temporary ischemia have any impact on our health? Prolonged pressure may temporarily cause superficial ischemia or numbness. If this occurs, regular breaks should be taken and pressure should be removed from the buttocks and testicles. Any injuries or damage to superficial body parts should be treated as soon as possible (cleaning the wound, applying a dressing, etc.). In the case of more serious conditions, a physician, such as a urologist or proctologist, should be consulted. Regardless of our clients' gender, we advise against purchasing gel saddles or any other saddles that are very wide and supposedly soft and comfortable. In our experience, such saddles often cause chafing. Does medical science have anything to say about this? Choosing the right saddle depends on many factors, including how long you'll be sitting, what type of cycling you'll be doing, and so on. Expert advice on this topic is undoubtedly crucial. We should strive to choose a saddle that won't cause mechanical trauma, abrasions, or pressure sores. However, there's no direct link between saddle choice and the occurrence of genitourinary tract diseases, including cancers. In cases of prostatitis, even in its chronic phase, prolonged cycling is not recommended due to possible irritation of the perineum, which can exacerbate symptoms associated with the condition. Finally, a question that goes beyond sports. I know you also work in the field of testicular cancer prevention. Could you share a few points about what to look out for and at what age should you have your testicles checked regularly? In Poland, the peak incidence of testicular cancer occurs between the ages of 20 and 39. The testicle is an organ that can be easily examined by men themselves. Therefore, we recommend regular self-examination of the testicles starting in their teens. This examination should be performed in a relaxed position, such as in the shower or bathtub, and involves slowly rolling (i.e., touching the testicle with two fingers). The entire testicle is examined, looking for lumps, hardening, or anything that may occur only in one testicle. In any abnormal situation, we should immediately consult a doctor, who will examine us and recommend a testicular ultrasound and blood tests to determine tumor marker levels. Men who had a testicle not descended into the scrotum at birth (undescended testicle at term), have testicular size abnormalities (one testicle is significantly smaller than the other, known as testicular dysgenesis), have difficulty having children (fertility problems), or have a family history of testicular cancer should be particularly careful with self-examination. With early diagnosis of this disease, we can achieve virtually 100% recovery, return to full health, and achieve, among other things, sporting successes, as exemplified by famous cyclists. In conclusion, we'll add that it's not only important to choose the right saddle, but also to properly adjust it. Even the ideal seat with the nose raised upwards can cause irreversible damage to the prostate. The saddle should be level with the ground, and in some cases, the nose may be slightly lowered. The rare exception are saddles with unusual shapes. Saddle selection is traditionally a trial-and-error process, but it's always worth seeking expert advice and using modern methods, such as measuring the distance between your sit bones. This will save you money and time, allowing you to fully enjoy your bike.