To better understand the etiology of recurrent urinary tract infection (UTI), the authors followed a cohort of 285 female college students with first UTI for 6 months or until second UTI. A first UTI due to Escherichia coli was followed by a second UTI three times more often than was a non-E. coli first UTI (24 vs. 8%; p = 0.02). In a logistic regression analysis limited to the 224 women from the University of Michigan Health Service and the University of Texas at Austin Health Service from September 1992 to December 1994, with a first UTI due to E. coli, vaginal intercourse increased the risk of a second UTI with both a different (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.19, 2.15) and the same (OR = 1.37, 95% CI: 0.91, 2.07) uropathogen, as did using a diaphragm, cervical cap, and/or spermicide (same uropathogen: OR = 1.53, 95% CI: 0.95, 2.47; different uropathogen: OR = 1.77, 95% CI: 1.22, 2.58). Condom use decreased the risk of a second UTI caused by a different uropathogen (OR = 0.68, 95% CI: 0.48, 0.99) but had no effect on a second UTI caused by the same E. coli (OR = 0.99; 95% CI: 0.66, 1.50). Type or duration of treatment was not associated with a second UTI. Although the risk of second UTI is strongly influenced by sexual behavior, women with a first UTI caused by E. coli are more likely than are those with a non-E. coli first UTI to have a second UTI within 6 months.

No abstract

No abstract

We describe the epidemiology of hysterectomy, overall as well as for specific indications. Data were obtained from the Epidemiologic Follow-up to the First National Health and Nutrition Examination Survey, a nationally representative cohort followed prospectively from the mid-1970s through 1992. Black and white women 25-49 years of age, interviewed during follow-up, were included in the analyses. The probability of undergoing a hysterectomy was estimated by demographic and reproductive factors. Hysterectomy as confirmed by hospital records was our main outcome measure. We found that women who had completed 9-11 years of education were more likely to have undergone a hysterectomy than were women with either more or less education. Women who had completed 9-11 years of education were also more likely to have had a hysterectomy because of menstrual problems. Three or more miscarriages, especially if caused by uterine prolapse, increased the probability of hysterectomy. Having had no live births decreased the probability of hysterectomy for menstrual disorders and uterine prolapse, but women who had their first child before age 20 were at increased risk of hysterectomy because of endometriosis. Hysterectomy appears to be associated with low education, high parity, and a history of multiple miscarriages. The influence of these factors varies depending on the primary indication for the hysterectomy.