Family Nurse Practitioner Exam

All of the following are risk factors for UTIs in women, except?

1. Diabetes mellitus

2. Diaphragms and spermicide use

3. Pregnancy

4. Intrauterine device

The correct answer is: Intrauterine device

The rationale for identifying intrauterine devices (IUDs) as an exception among the listed risk factors for urinary tract infections (UTIs) in women lies in understanding how these contraceptive methods interact with the urogenital tract. IUDs, especially the hormonal types, do not significantly increase the risk of UTIs. In fact, some research suggests that they may have a neutral or even protective effect in certain populations. The mechanism thought to be at play is that IUDs do not generally alter the vaginal flora or create an environment conducive to bacterial growth like some other contraceptive methods do. In contrast, diabetes mellitus, diaphragm and spermicide use, and pregnancy have established links to increased UTI risks. Diabetes can lead to higher glucose levels in urine, which promotes bacterial growth. Diaphragms and spermicides can irritate the genital tract and alter the natural flora, making it easier for infections to occur. Additionally, pregnancy leads to anatomical and hormonal changes that can predispose women to UTIs, such as increased urinary stasis and altered immune response. Thus, understanding these dynamics clarifies why the use of an intrauterine device is not considered a risk factor in relation to UTIs in women.