Bacteriuria in young women Effect of estrogen, progestogen, and estrogen-progestogen combination

Intrauterine devices as an exposure risk for urinary tract infections: A scoping review

“…Corriere et al reported a randomized controlled study of UTI incidence among patients on different oral anovulatory medications within the University of Pennsylvania hospital system 26 . Eighty‐two women (age range: 18–32 years) were assigned to 12, 3‐week long cycles of either estrogen (n = 21), progestogen (n = 22), estrogen–progestogen (n = 22), or placebo (n = 17).…”

“…Five of nine studies identified UTI by the presence of a single positive urine culture and/or dipstick, 20,23‐26 while four studies relied on qualitative urinary symptoms 17,18,20,27 17,18,21,26 . Specifically, while the McGeer definition (1991) characterized a UTI by the presence of urinary symptoms and fever, 28 subsequent literature has revealed an error rate as high as 33% when diagnosing UTI by clinical criteria alone 29 .…”

“…Among the included studies, criteria for diagnosing a UTI were variable (Table 1). Five of nine studies identified UTI by the presence of a single positive urine culture and/or dipstick, 20,[23][24][25][26] while four studies relied on qualitative urinary symptoms. 17,18,20,27 These differences may reflect an evolving understanding of the UTI phenotype, with four studies published prior to the year 2000.…”

“…Relatedly, varied comparison groups between studies complicated our synthesis of the findings. Five of the nine studies evaluated (1) IUD insertion against hysterectomy, 27 (2) IUD insertion against tubal ligation, 25 (3) long-term use of IUD against OCP use, 23 (4) different oral hormonal combinations among women all fitted with a common IUD, 26 and (5) a single timepoint measurement of bacteriuria prevalence in patients using either IUD or OCPs for contraception. 21 The diversity of these comparator groups highlights the need for clearly defined cases and controls in future studies.…”

“…One randomized controlled trial evaluated UTI incidence among patients using the Lippes Loop D device with or without other methods of contraception. 26 While the Lippes Loop was a popular IUD during the 1960s to 1980s, levonorgestrel-eluting and copper IUDs have since outcompeted this product due to superior effectiveness and side effect profiles. 34 This study was included as a historical comparison for completeness.…”