VAGINAL SPERMICIDES AND URINARY TRACT INFECTIONS

阴道杀精剂和尿路感染

• 批准号: 3242062
• 负责人: STEPHAN D FIHN
• 金额: $ 13.8万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-03-01 至 1994-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3242062
• 关键词: automated medical record system; disease /disorder proneness /risk; drug adverse effect; epidemiology; female; health surveys; interview; nondrug contraceptive; public health; questionnaires; spermicide; statistics /biometry; urinary tract infection

Barrier methods of contraception that include a spermicide are increasingly being used to prevent pregnancy and sexually transmitted diseases. Nine independent studies, including two of our own, have demonstrated that women using a diaphragm have a 2 to 3-fold higher risk of urinary tract infection (UTI) than sexually active women using other forms of contraception. The mechanism of this predisposition to UTI is unknown. Although some authors postulate that diaphragms cause urethral obstruction, our investigations indicate that this is not a critical factor. On the contrary, our work shows that diaphragm use is associated with major alterations in the normal vaginal flora similar to those found in women with recurrent UTI. These changes likely result, at least in part, from spermicidal agents used in conjunction with the diaphragm. We hypothesize that women using spermicides without a diaphragm are also at increased risk for UTI. To test this directly, we will perform a case-control study to determine whether women who use vaginal spermicides are at higher risk of UTI than women using other forms of contraception. This study will be carried out in conjunction with the Center for Health Studies at Group Health Cooperative of Puget Sound which has extensive experience with similarly designed epidemiologic investigations regarding reproductive health and behavior. With 320,000 enrollees, the Cooperative has a large membership which is representative of the Puget Sound Region as a whole. Using automated records at Group Health Cooperative, we will identify 600 women who have been treated for a UTI (study cases) and 600 randomly selected women who have not had a recent UTI (controls). These records contain a surfeit of eligible cases so we will randomly select cases. stratified by age and marital status. Cases and controls will then be compared with regard to the frequency of exposure to spermicides after adjusting for the confounding effects of variables such as sexual activity, history of prior UTI and voiding practices. Since up to one third of all UTIs in young women may result from diaphragm use, these studies will be important in better defining the mechanism involved and in delineating the risks of UTI in women who use vaginal spermicides without a diaphragm.

包含杀精剂的屏障避孕方法是 越来越多地用于预防怀孕和性传播 疾病。 九项独立研究，包括我们自己的两项研究， 研究表明，使用隔膜的女性患此病的风险要高出 2 至 3 倍 尿路感染 (UTI) 率高于性活跃女性使用其他形式的尿路感染 (UTI) 避孕。 这种尿路感染易感性的机制尚不清楚。 尽管一些作者假设隔膜会导致尿道阻塞， 我们的调查表明这不是一个关键因素。 上 相反，我们的工作表明隔膜的使用与主要 正常阴道菌群的改变与女性相似 患有复发性尿路感染。 这些变化可能至少部分是由于 与隔膜一起使用的杀精剂。 我们假设使用无隔膜杀精剂的女性 尿路感染的风险也增加。 为了直接测试这一点，我们将执行 病例对照研究以确定使用阴道杀精剂的女性是否 与使用其他形式避孕的女性相比，她们患尿路感染的风险更高。 这项研究将与健康中心联合进行 普吉特海湾团体健康合作社的研究，该合作社拥有广泛的 具有类似设计的流行病学调查经验 生殖健康和行为。 合作社拥有 320,000 名注册者 拥有大量代表普吉特海湾地区的会员 一个整体。 使用团体健康合作社的自动记录，我们将识别 600 名接受过尿路感染治疗的女性（研究案例）和 600 名随机 选定最近没有患过尿路感染的女性（对照）。 这些记录 包含过多的符合条件的案例，因此我们将随机选择案例。 按年龄和婚姻状况分层。 然后案例和控制将 与接触杀精剂后的频率进行比较 调整性活动等变量的混杂影响， 既往尿路感染史和排尿习惯。 由于年轻女性中多达三分之一的尿路感染可能是由 隔膜的使用，这些研究对于更好地定义隔膜的使用非常重要 涉及并描述使用该药物的女性患尿路感染的风险的机制 没有隔膜的阴道杀精剂。