The rectouterine pouch (recto-uterine pouch), pouch of Douglas, or rectovaginal pouch is the extension of the peritoneum between the rectum and the posterior wall of the uterus in the human female. Its anterior boundary is formed by the posterior fornix of the vagina.[1]
Rectouterine pouch
Sagittal section of the lower part of a female trunk, right segment. (Excavatio recto-uterina labeled at bottom right.)
Median sagittal section of female pelvis. (Rectouterine excavation labeled at center left.)
In women, the rectouterine pouch is the deepest point of the peritoneal cavity. It lies posterior to the uterus and anterior to the rectum.[2] (The pouch on the other side of the uterus is the vesicouterine pouch.) It is near the posterior fornix of the vagina.
It is normal to have approximately 1 to 3 ml (or mL) of fluid in the rectouterine pouch throughout the menstrual cycle.[3] After ovulation there is between 4 and 5 ml of fluid in the rectouterine pouch.[3]
In men, the region corresponding to the rectouterine pouch is the rectovesical pouch, which lies between the urinary bladder and rectum.
Clinical significance
The rectouterine pouch, being the lowest part of the peritoneal cavity in a woman at supine position, is a common site for the spread of pathology such as ascites, tumour, endometriosis, pus, etc.
As it is the furthest point of the abdominopelvic cavity in women, it is a site where infection and fluids typically collect.[4]
The rectouterine pouch can be used in the treatment of end-stage kidney failure in patients who are treated by peritoneal dialysis. The tip of the dialysis catheter is placed into the deepest point of the pouch.
Culdocentesis
Culdocentesis is a procedure that draws fluid from the pouch, by way of the vagina using a needle. Fluid drawn using a scalpel incision is called a colpotomy.
Naming and etymology
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,[5] Douglas cavity,[5] Douglas space,[5] Douglas cul-de-sac,[5] Ehrhardt–Cole recess, Ehrhardt–Cole cul-de-sac, cavum Douglasi, or excavatio rectouterina. The combining forms reflect the rectum (recto-, -rectal) and uterus (utero-, -uterine).
^Woodward, Paula J.; Griffith, James F.; Antonio, Gregory E.; Ahuja, Anil T., eds. (2018-01-01), "Ureters and Bladder", Imaging Anatomy: Ultrasound (Second Edition), Elsevier, pp. 424–433, ISBN978-0-323-54800-7, retrieved 2021-02-03
^ abSeveri FM, Bocchi C, Vannuccini S, Petraglia F (2012). "Ovary and ultrasound: from physiology to disease" (PDF). Archives of Perinatal Medicine. 18 (1): 7–19.
^Drake, RL (2010). Gray's Anatomy for Students. Churchill Livingstone. p. 460.
^Hensen, Jan-Hein J.; Puylaert, Julien B. C. M. (2009-06-01). "Endometriosis of the Posterior Cul-De-Sac: Clinical Presentation and Findings at Transvaginal Ultrasound". American Journal of Roentgenology. 192 (6): 1618–1624. doi:10.2214/AJR.08.1807. ISSN 0361-803X. PMID 19457826.
Gullmo A (1980). "Herniography. The diagnosis of hernia in the groin and incompetence of the pouch of Douglas and pelvic floor". Acta Radiologica. Supplementum. 361: 1–76. PMID 6297246.
Anaf V, Simon P, El Nakadi I, Simonart T, Noel J, Buxant F (February 2001). "Impact of surgical resection of rectovaginal pouch of douglas endometriotic nodules on pelvic pain and some elements of patients' sex life". The Journal of the American Association of Gynecologic Laparoscopists. 8 (1): 55–60. doi:10.1016/s1074-3804(05)60549-x. PMID 11172115.
Baessler K, Schuessler B (March 2000). "The depth of the pouch of Douglas in nulliparous and parous women without genital prolapse and in patients with genital prolapse". American Journal of Obstetrics and Gynecology. 182 (3): 540–4. doi:10.1067/mob.2000.104836. PMID 10739505.
Ostör AG, Nirenberg A, Ashdown ML, Murphy DJ (June 1994). "Extragenital adenosarcoma arising in the pouch of Douglas". Gynecologic Oncology. 53 (3): 373–5. doi:10.1006/gyno.1994.1151. PMID 8206414.
Tsin, DA (2001). "Culdolaparoscopy: a preliminary report". JSLS. 5 (1): 69–71. PMC3015410. PMID 11303998.
External links
Anatomy photo:43:02-0300 at the SUNY Downstate Medical Center - "The Female Pelvis: Distribution of the Peritoneum in the Female Pelvis"
Anatomy image:9610 at the SUNY Downstate Medical Center
Anatomy image:9737 at the SUNY Downstate Medical Center
peritoneum at The Anatomy Lesson by Wesley Norman (Georgetown University)
figures/chapter_35/35-8.HTM: Basic Human Anatomy at Dartmouth Medical School
. Roche Lexicon - illustrated navigator. Elsevier. Archived from the original on 2015-06-11.
December 27, 2022
rectouterine, pouch, rectouterine, pouch, recto, uterine, pouch, pouch, douglas, rectovaginal, pouch, extension, peritoneum, between, rectum, posterior, wall, uterus, human, female, anterior, boundary, formed, posterior, fornix, vagina, sagittal, section, lowe. The rectouterine pouch recto uterine pouch pouch of Douglas or rectovaginal pouch is the extension of the peritoneum between the rectum and the posterior wall of the uterus in the human female Its anterior boundary is formed by the posterior fornix of the vagina 1 Rectouterine pouchSagittal section of the lower part of a female trunk right segment Excavatio recto uterina labeled at bottom right Median sagittal section of female pelvis Rectouterine excavation labeled at center left DetailsIdentifiersLatinexcavatio rectouterina cavum douglassi fossa douglasiMeSHD004312TA98A10 1 02 512FTA23726FMA14728Anatomical terminology edit on Wikidata Contents 1 Structure 2 Clinical significance 2 1 Culdocentesis 3 Naming and etymology 4 In popular culture 5 Additional images 6 See also 7 References 8 Further reading 9 External linksStructure EditIn women the rectouterine pouch is the deepest point of the peritoneal cavity It lies posterior to the uterus and anterior to the rectum 2 The pouch on the other side of the uterus is the vesicouterine pouch It is near the posterior fornix of the vagina It is normal to have approximately 1 to 3 ml or mL of fluid in the rectouterine pouch throughout the menstrual cycle 3 After ovulation there is between 4 and 5 ml of fluid in the rectouterine pouch 3 In men the region corresponding to the rectouterine pouch is the rectovesical pouch which lies between the urinary bladder and rectum Clinical significance EditThe rectouterine pouch being the lowest part of the peritoneal cavity in a woman at supine position is a common site for the spread of pathology such as ascites tumour endometriosis pus etc As it is the furthest point of the abdominopelvic cavity in women it is a site where infection and fluids typically collect 4 The rectouterine pouch can be used in the treatment of end stage kidney failure in patients who are treated by peritoneal dialysis The tip of the dialysis catheter is placed into the deepest point of the pouch Culdocentesis Edit Culdocentesis is a procedure that draws fluid from the pouch by way of the vagina using a needle Fluid drawn using a scalpel incision is called a colpotomy Naming and etymology EditThe 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 5 Douglas cavity 5 Douglas space 5 Douglas cul de sac 5 Ehrhardt Cole recess Ehrhardt Cole cul de sac cavum Douglasi or excavatio rectouterina The combining forms reflect the rectum recto rectal and uterus utero uterine In Obstetrics and gynaecology it is commonly referred to as the pouch of Douglas or the posterior cul de sac 6 The Douglas fold rectouterine plica Douglas line and Douglas septum are likewise named after the same James Douglas In popular culture EditThe Pouch of Douglas was featured in the Netflix special Hannah Gadsby Douglas to deconstruct patriarchy 7 In Ghost World the Trivia Question at the Cafe where Scarlett Johansson s character works is where in the human body is the Douglas Pouch located Additional images Edit The epiploic foramen greater sac or general cavity red and lesser sac or omental bursa blue Illu female pelvisSee also EditDolichodouglas Vesicouterine excavationReferences Edit Vasu Balaji Rectouterine pouch Radiology Reference Article Radiopaedia org Radiopaedia Retrieved 27 September 2021 Woodward Paula J Griffith James F Antonio Gregory E Ahuja Anil T eds 2018 01 01 Ureters and Bladder Imaging Anatomy Ultrasound Second Edition Elsevier pp 424 433 ISBN 978 0 323 54800 7 retrieved 2021 02 03 a b Severi FM Bocchi C Vannuccini S Petraglia F 2012 Ovary and ultrasound from physiology to disease PDF Archives of Perinatal Medicine 18 1 7 19 Drake RL 2010 Gray s Anatomy for Students Churchill Livingstone p 460 a b c d synd 2937 at Who Named It Hensen Jan Hein J Puylaert Julien B C M 2009 06 01 Endometriosis of the Posterior Cul De Sac Clinical Presentation and Findings at Transvaginal Ultrasound American Journal of Roentgenology 192 6 1618 1624 doi 10 2214 AJR 08 1807 ISSN 0361 803X PMID 19457826 Hannah Gadsby Douglas review Rolling StoneFurther reading EditGullmo A 1980 Herniography The diagnosis of hernia in the groin and incompetence of the pouch of Douglas and pelvic floor Acta Radiologica Supplementum 361 1 76 PMID 6297246 Anaf V Simon P El Nakadi I Simonart T Noel J Buxant F February 2001 Impact of surgical resection of rectovaginal pouch of douglas endometriotic nodules on pelvic pain and some elements of patients sex life The Journal of the American Association of Gynecologic Laparoscopists 8 1 55 60 doi 10 1016 s1074 3804 05 60549 x PMID 11172115 Baessler K Schuessler B March 2000 The depth of the pouch of Douglas in nulliparous and parous women without genital prolapse and in patients with genital prolapse American Journal of Obstetrics and Gynecology 182 3 540 4 doi 10 1067 mob 2000 104836 PMID 10739505 Ostor AG Nirenberg A Ashdown ML Murphy DJ June 1994 Extragenital adenosarcoma arising in the pouch of Douglas Gynecologic Oncology 53 3 373 5 doi 10 1006 gyno 1994 1151 PMID 8206414 Tsin DA 2001 Culdolaparoscopy a preliminary report JSLS 5 1 69 71 PMC 3015410 PMID 11303998 External links EditAnatomy photo 43 02 0300 at the SUNY Downstate Medical Center The Female Pelvis Distribution of the Peritoneum in the Female Pelvis Anatomy image 9610 at the SUNY Downstate Medical Center Anatomy image 9737 at the SUNY Downstate Medical Center Douglas Pouch at the US National Library of Medicine Medical Subject Headings MeSH peritoneum at The Anatomy Lesson by Wesley Norman Georgetown University figures chapter 35 35 8 HTM Basic Human Anatomy at Dartmouth Medical School Anatomy diagram 03281 000 2 Roche Lexicon illustrated navigator Elsevier Archived from the original on 2015 06 11 Retrieved from https en wikipedia org w index php title Rectouterine pouch amp oldid 1115837728, wikipedia, wiki, book, books, library,
