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The rectouterine pouch (rectovaginal pouch, pouch of Douglas or cul-de-sac) is the extension of the peritoneum into the space between the posterior wall of the uterus and the rectum in the human female.
Culdocentesis is a medical procedure involving the extraction of fluid from the rectouterine pouch (pouch of Douglas) [1] posterior to the vagina through a needle. It can be one diagnostic technique used in identifying pelvic inflammatory disease (in which case purulent fluid will be extracted) and ruptured ectopic pregnancies that cause hemoperitoneum.
Culdoscopy is an endoscopic procedure performed to examine the rectouterine pouch and pelvic viscera by the introduction of a culdoscope through the posterior vaginal wall. [1] The word culdoscopy (and culdoscope) is derived from the term cul-de-sac, which means literally in French "bottom of a sac", and refers to the rectouterine pouch (or called the pouch of Douglas).
However, a large rectocele that retains contrast medium may hide a cul-de-sac hernia. [3] Cul-de-sac hernia (peritoneocele / omentocele) may appear on fluoroscopic defecography as an un-opacified mass which deforms the anterior border of the rectum and the posterior border of the vagina, with widening of the recto-vaginal space in between. [1]
Posterior enterocele (develops in the rectovaginal space, also termed the pouch of Douglas or the cul-de-sac). [2] Anterior enterocele (develops in the vesicovaginal space). [2] Retains the full thickness of the anterior vaginal wall. [2] Lacks vaginal wall (or very thin and ulcerated vaginal wall). [2] Anterior enterocele is rare. [2]
The word culdoscope (and culdoscopy) is derived from the phrase cul-de-sac, which in French literally means "bottom of a sac", here referring to a blind pouch or cavity in the female body that is closed at one end, that is the rectouterine pouch. As early as the 13th century, a cul-de-sac was a dead-end street (or a dead-end way), a blind alley ...
The vesicouterine pouch is a fold of peritoneum over the uterus and the bladder, forming a pelvic recess. [1] It is continued over the intestinal surface and body of the uterus onto its vesical surface, which it covers as far as the junction of the body and cervix uteri, and then to the bladder.
Although a pouch of Douglas hernia, originating in the cul de sac of Douglas, may protrude from the anus (via the anterior rectal wall), [21] this is a different situation from rectal prolapse. Shortly after the invention of defecography , In 1968 Broden and Snellman used cinedefecography to show that rectal prolapse begins as a circumferential ...