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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.
The rectouterine (or recto-uterine) pouch is also called the rectouterine excavation, uterorectal pouch, rectovaginal pouch, pouch of Douglas (after anatomist James Douglas, 1675–1742), Douglas pouch, [6] Douglas cavity, [6] Douglas space, [6] Douglas cul-de-sac, [6] Ehrhardt–Cole recess, Ehrhardt–Cole cul-de-sac, cavum Douglasi, or excavatio rectouterina.
In terms of pelvic organ prolapse, a cul-de-sac hernia is located in the posterior compartment of the pelvis. [5] A true cul-de-sac hernia contains only omental fat, and often intraperitoneal liquid. [6] If the hernia contains omentum, sometimes the term "omentocele" is used. [7]
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).
They form dark, fluid-filled cysts, [4] which can vary greatly in size. The fluid inside the cysts is thick, dark, old blood, giving it a chocolate-like appearance, giving it the name chocolate cyst. It can also develop in the cul-de-sac (the space behind the uterus), the surface of the uterus, and between the vagina and rectum. [5]
She also programmed pre-run stretches and exercises to help engage and relax my pelvic floor. Over the 16 weeks, I built up running volume with a peak of 33 miles in one week and one 20-mile long run.
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.
The rectovesical pouch is a space between the rectum and the bladder in men. [1] It lies above the seminal vesicles. [2] It is lined by peritoneum and at its base is the rectoprostatic fascia (Denonvillier's fascia).