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

Abstract

Background The intrauterine device (IUD) as a potential source of uro‐gynecologic infection has raised concern for decades. While a causal link between IUD and pelvic inflammatory disease has been refuted, the relationship between IUDs and urinary tract infections (UTIs) remains incompletely understood. Methods We used a PubMed, CINAHL, and Cochrane Library search strategy to identify studies evaluating UTI occurrence and microbial signatures among women exposed to IUD. We evaluated the question, "what is currently known about the IUD as an exposure risk for UTIs?" Results Nine studies met inclusion criteria and were summarized in this structured, scoping review. Studies to date have not reported a significant association between IUD exposue and UTI occurence. While all nine studies acknowledged the breadth of contraceptive methods, none evaluated the impact of different IUD types (i.e., copper vs. hormone‐eluting) on UTI incidence. Conclusion Small sample sizes and inconsistent UTI definitions limit the current literature. Future studies should rigorously define the UTI phenotype and evaluate the association of UTI with IUD exposure accounting for known covariates.

Infectious Diseases Specific to Women

“…CAUTI not only lowers the threshold for infection but can also lead to increased antimicrobial resistance and colonization of the urinary tract by more gram-positive pathogens such as Enterococcus spp and Staphylococcus aureus (methicillin-sensitive or methicillin-resistant), including fungal species such as Candida spp 34. It is critical to consider IUDs as an esoteric cause of lower UTs that can manifest in abscesses 35…”

“…34 It is critical to consider IUDs as an esoteric cause of lower UTs that can manifest in abscesses. 35…”