title: Genitourinary infections after a routine pelvic exam.
abstract: OBJECTIVE
  To determine if genitourinary problems are more common in women in the first 1 to 2 months after a routine pelvic examination.
  
  
  METHODS
  This was a historical cohort study in 2 family medicine teaching clinics at an urban university. Participants included all women who received a Papanicolaou smear during calendar year 2006. Subjects included all participants for weeks 1 to 7 after their Papanicolaou smear. Controls were all participants in weeks 8 to 52 after their Papanicolaou smear. The independent variable was time after Papanicolaou smear, and dependent variables included frequency of visits for urinary complaints, diagnosed urinary tract infections (UTIs), vaginal complaints, diagnosed vaginitis, and sexually transmitted diseases. Relative frequencies compared using 2-tailed t tests.
  
  
  RESULTS
  UTIs and urinary complaints were significantly more frequent during the first 7 weeks after a Papanicolaou smear compared with weeks 8 to 14, 8 to 48, and 8 to 52. The overall rate of UTIs was 7.33 per 100 person-years; the attributable risk during the first 7 weeks was 0.82 per 100 person-years, or 11% of observed UTIs. Combined Candidal and bacterial vaginitis was marginally more frequent during the first 7 weeks compared with weeks 8 to 48 and 8 to 52 only. The incidence of sexually transmitted diseases combined was 1.13 per 100 person-years, distributed evenly over the study period unrelated to time.
  
  
  CONCLUSIONS
  The risk of UTI is increased in the 7 weeks after a Papanicolaou smear.
authors.affiliation: Family Medicine Center, University of Illinois at Chicago College of Medicine Chicago, Chicago, IL 60607, USA. jtiemstr@uic.edu
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Tiemstra
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Chico
authors.forename: Emily
authors.initials: E
authors.lastname: Pela
mesh_terms: D000328:Adult; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000209:etiology*; D058869:Gynecological Examination / Q000009:adverse effects*; D006785:Hospitals, University; D006801:Humans; D065006:Papanicolaou Test; D005791:Patient Care; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000209:etiology*; D014621:Vagina; D014626:Vaginal Smears / Q000009:adverse effects*