A Cochrane review [Abstract] 1 included 11 studies with a total of 4 416 couples. The Peto odds ratio (OR) of total clinical failure for the nonlatex vs latex condoms ranged from 1.9 (95% CI 1.3 to 3.0) to 4.4 (95% CI 3.5 to 5.5) for 8 comparisons and was not statistically significantly different for 3 comparisons. Clinical breakage was responsible for the higher rates of condom failures with the nonlatex condoms. The OR of clinical breakage for the nonlatex vs latex condoms ranged from 2.6 (95% CI 1.6 to 4.3) to 5.0 (95% CI 3.6 to 6.8). Substantial proportions of participants preferred the nonlatex condom or reported that they would recommend its use to others.
A randomised, masked, 3 way crossover, multicentre controlled study 2 including 300 heterosexual couples assessed clinical breakage, slippage and acceptability of 2 commercial ultra-thin polyurethane male condoms compared to a commercial thin latex condom. Although the total failure rates (breakage and slippage) for the polyurethane condoms were higher than for the control latex condom, all condoms performed extremely well with low failure rates compared to similar condom studies.
Comment:Pregnancy rates were usually not compared. Breakage has not been established as a valid proxy measure for contraceptive efficacy. Quality of evidence is downgraded by indirectness and inconsistency.
Primary/Secondary Keywords