Several mechanisms maintain the sterility of the bladder. Abnormalities or dysfunctions of these mechanisms are contributing risk factors for lower UTIs. Which are risk factors for UTIs? (Select all that apply)

Urinary tract infections occur when uropathogens overcome the body’s innate immune defenses and mechanical flushing mechanisms. Factors that promote urinary stasis, increase glucose availability for bacterial growth, or cause anatomical compression of the urinary tract significantly elevate the risk of colonization and subsequent infection. A. Gout is a metabolic disorder characterized by the accumulation of uric acid crystals in the joints. While it can lead to uric acid kidney stones (urolithiasis), it is not a direct primary risk factor for the development of lower urinary tract infections in the same way that metabolic or structural dysfunctions are. B. Neurologic disorders, such as multiple sclerosis or spinal cord injuries, often result in a neurogenic bladder. This leads to incomplete bladder emptying and urinary stasis. Stagnant urine provides a stable environment for bacteria to multiply, bypassing the natural "washout" effect of regular, forceful micturition. C. Diabetes mellitus increases UTI risk due to glucosuria, which provides an ideal nutrient-rich culture medium for bacterial proliferation. Additionally, long-term diabetes can cause autonomic neuropathy leading to bladder dysfunction, and the associated impaired immune response reduces the body’s ability to clear invading pathogens effectively. D. Male gender is generally a protective factor against UTIs due to a longer urethra and the presence of prostatic antibacterial secretions. Recurrent UTIs in males are usually considered complicated and are often related to functional or structural abnormalities, rather than gender itself being a "risk factor." E. Pregnancy is a significant risk factor due to both hormonal and mechanical changes. Progesterone causes smooth muscle relaxation, leading to ureteral dilation and urinary stasis. Furthermore, the enlarging uterus physically compresses the bladder and ureters, impeding flow and facilitating the upward migration of bacteria.