Abstract

PIP: The use of condoms lubricated with nonoxynol-9 has been associated, in one case-control study, with an increased risk of urinary tract infection (UTI) and, in another, with a reduced risk of UTI. Despite the lack of research on the effects of nonoxynol-9, the US Surgeon General has recommended the addition of at least 65 mg of the spermicide with condoms. Especially in high doses or with frequent application, nonoxynol-9 may cause vaginal or urethral irritation. Preliminary studies suggest it may also change the character of vaginal fluids, alter the capacity of different organisms to bind to the vaginal epithelium, and suppress Lactobacillus growth without influencing Escherichia coli growth. Since neither case-control study provided evidence of an increased risk of UTI associated with the use of lubricated condoms without nonoxynol-9, promotion of nonspermicidal lubricated condoms remains the most feasible approach to the prevention of pregnancy and sexually transmitted diseases. Needed are more well-designed prospective studies to assess the risk factors for UTI--a major cause of morbidity among US women.