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  • Title: Association between diaphragm use and asymptomatic bacteriuria.
    Author: Peddie BA, Bishop VA, Blake EE, Gorrie SI, Bailey RR, Edwards D.
    Journal: Aust N Z J Obstet Gynaecol; 1986 Aug; 26(3):225-7. PubMed ID: 3545172.
    Abstract:
    The prevalence of asymptomatic bacteriuria was assessed in women using different contraceptive methods. Three hundred and twenty women attending a family planning centre were studied, 80 in each of the following groups: diaphragms, intrauterine contraceptive devices (IUCDs), oral contraceptives (OCs) and no contraception. The numbers with asymptomatic bacteriuria in the 4 groups were as follows: diaphragm - 12 (all E coli); IUCD - 3 (E coli; P mirabilis; S saprophyticus); OC - 5 (all E coli); no contraception - 4 (3 E coli; 1 S saprophyticus). The prevalence of Gram-negative bacteriuria in women using diaphragms was significantly higher than for women in the other groups (chi 2 = 8.98; p less than 0.05). Factors such as parity, numbers of sexual partners and frequency of sexual intercourse had no apparent effect. The use of diaphragms may contribute to the risk of Gram-negative urinary tract infections in sexually active women. A prospective study was carried out to determine whether the prevalence of asymptomatic bacteriuria in women is affected by contraceptive method. Study subjects included 320 women attending a family planning center who were divided into 4 groups according to contraceptive method: diaphragm (80 women), IUD (80 women), oral contraceptives (80 women), and no contraceptive method (80 women). Diaphragm users were found to have a significantly higher incidence of bacteriuria (p 0.05) than women in the other 3 contraceptive groups. Escherichia coli was the organism isolated from all of the women using diaphragms who had asymptomatic infection. 3 of these 12 women reported having had urinary tract symptoms in the preceding year. Parity, number of sexual partners, and frequency of intercourse did not have an effect on the prevalence rate of asymptomatic urinary tract infection in the different contraceptive groups. The 15% prevalence rate of asymptomatic bacteriuria found in this study among diaphragm users is 3 times the rate found in pregnancy or among sexually active nonpregnant women. Overall, these findings support the view that diaphragm use contributes to the risk of urinary tract infections with Gram-negative organisms.
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