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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).
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.
Anatomy photo:43:10-0201 at the SUNY Downstate Medical Center – "The Female Pelvis: The Vagina" Histology image: 19401loa – Histology Learning System at Boston University – "Female Reproductive System: cervix, longitudinal" figures/chapter_35/35-2.HTM: Basic Human Anatomy at Dartmouth Medical School
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 ...
A cul-de-sac hernia (also termed a peritoneocele) is a herniation of peritoneal folds into the rectovaginal septum (in females), [2] or the rectovesical septum (in males). The herniated structure is the recto-uterine pouch (pouch of Douglas) in females, [ 2 ] or the rectovesical pouch in males.
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.
In addition, some deep lesions are present in the cul-de-sac. Stage III (Moderate) As above, plus the presence of endometriomas on the ovary and more adhesions. Stage IV (Severe) As above, plus large endometriomas, extensive adhesions. Implants and adhesions may be found beyond the uterus. Large ovarian cysts are common.
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]