14 Tampon use has been associated with both the toxic shock syndrome and bacterial vaginosis. A serendipitous discovery on nuclear scan of a tampon causing asymmetric bladder filling lends weight to the hypothesis that the presence of an intravaginal tampon can be a factor in a functional obstruction, similar to that mechanism postulated regarding diaphragm use. Collectively this data suggests that tampon use may be associated with an alteration in bladder anatomy, vaginal mucosa and pH in some women. These changes may result in increased vaginal colonisation with E.coli. Then in susceptible women, the insertion and removal of the tampon may facilitate the spread of these bacteria from the vagina to the urethra and bladder.
Further study is required to establish tampon use as a definite risk factor for recurrent UTIs.
We suggest physicians routinely enquire about tampon use when they encounter women with recurrent cystitis. Detection, prevention and management of urinary tract infections. Lea and Febiger, 1987. Management of urinary tract infection in adults. Sexual intercourse and urinary infections.