Sulcus nervi dorsalis penis: Site of origin of Alcock’s syndrome in bicycle riders?

Abstract

This article introduces a hypothesis that the pudendal nerve compression syndrome, also known as the Alcock's syndrome in long-time duration bicycle riders might be caused by an irritation of the dorsal nerve of penis in a groove on the inferior ramus and the anterior surface of pubis, previously described by authors as the sulcus nervi dorsalis penis. Alcock's syndrome in bicycle riders has been characterized as a prolonged glans and penile insensitivity, genital numbness and an erectile dysfunction. Although no anorectal pain or disturbance of the bulbocavernosus reflex has been reported in these patients, we assume it cannot be caused by a compression of the pudendal nerve in pudendal (Alcock's) canal, hence by a compression of the dorsal nerve of penis in the sulcus nervi dorsalis penis. In future, if clinical studies confirm our hypothesis, it might be more sophisticated to evaluate this syndrome apart from the Alcock's syndrome and term it the dorsal nerve compression syndrome rather than the Alcock's syndrome.