Urinary Tract Infections in Active Component U.S. Armed Forces Women Before and After Routine Screening Pap...

It has been suggested that Pap tests, when used as surrogate markers for routine pelvic examinations in asymptomatic women, may be associated with an increased short-term risk of urinary tract infections (UTIs). This retrospective cohort study used Defense Medical Surveillance System (DMSS) data from 2007 through 2013 to compare the incidence of UTIs in active component women before and after receiving a routine screening Pap examination. The pre-Pap (baseline) UTI incidence rate in this cohort was 105.9 per 1,000 person-years (p-yrs) compared to 129.8 per 1,000 p-yrs post-Pap; the rate ratio was 1.23 (95% CI: 1.18-1.27). The adjusted relative risk of UTI post-Pap was 1.14 (95% CI: 1.10-1.18) and the adjusted percentage of UTIs attributable to a Pap test in the post-exposure period was 12.2% (95% CI: 9.1-15.2). Routine Pap tests, when used as a surrogate marker for pelvic examination, may be a modifiable risk factor for UTI in active component U.S. military women.