Urinary tract infections among diaphragm users

An association between diaphragm use and the subsequent development of lower urinary tract infections (urethritis, cystitis, etc) has been suggested by two recent studies in the literature. The present study uses a case-control approach to determine the relative risk of developing urinary tract infections among diaphragm users aged 15 to 45 years during a 15-month period. Patient charts at a family practice clinic were reviewed for evidence of documented urinary tract infections and method of contraception (n = 98). As a control, all women aged 15 to 45 years seen for upper respiratory tract infection during the same period were reviewed (n = 126). Depending upon how a urinary tract infection was defined (urinalysis positive, culture positive, both positive), the relative odds for the development of subsequent urinary tract infections range from 0.88 to 1.10. When all barrier methods were considered together, this odds ratio ranged from 0.88 to 1.21. Documentation of symptoms and laboratory confirmation of urinary tract infection were lacking in many charts reviewed. Despite these limitations, the study findings call into question the assumption that diaphragm use may lead to the subsequent development of urinary tract infection.