Recto-uterine pouch

The recto-uterine pouch (or rectouterine excava- 5 Clinical signicance

tion, rectovaginal, Ehrhardt-Cole Recess, cul-de-sac,
cavum Douglasi or Pouch of Douglas) is the extension As it is the furthest point of the abdominopelvic cavity
of the peritoneal cavity between the rectum and the pos- in women, it is a site where infection and uids typically
terior wall of the uterus in the female human body.
collect.[3]

The recto-uterine pouch is used in the treatment of endstage renal failure in patients who are treated by peritoneal
dialysis. The tip of the dialysis catheter is placed into the
deepest point of the pouch.

Structure and physiology

In women it is the deepest point of the peritoneal cavity,

posterior to (behind) the uterus and anterior to (in front
of) the rectum. (The pouch on the other side of the uterus
is the vesico-uterine pouch.) It is near the posterior fornix
of the vagina.

6 Additional images
The epiploic foramen, greater sac or general cavity
(red) and lesser sac, or omental bursa (blue).

It is normal to have approximately 1 to 3 ml in the rectouterine pouch throughout the menstrual cycle.[1] After
ovulation there is between 4 and 5 ml of uid in the rectouterine pouch.[1]

Illu female pelvis

In men, the region corresponding to the recto-uterine

pouch is the recto-vesical pouch, which lies between the
urinary bladder and rectum. (There is no equivalent to
the vesico-uterine pouch).

7 See also
Vesicouterine excavation

8 References

Pathology

[1] Severi FM, Bocchi C, Vannuccini S, Petraglia F (2012).

Ovary and ultrasound: from physiology to disease
(PDF). Archives of Perinatal Medicine 18 (1): 719.

The recto-uterine 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.

[2] synd/2937 at Who Named It?

[3] Drake, RL (2010).
Grays Anatomy for Students.
Churchill Livingstone. p. 460.

Naming and etymology

9 Further reading

It is also known by the names Douglas pouch, Douglas

cavity, Douglas space and Douglas cul-de-sac.[2]

Gullmo A (1980). Herniography. The diagnosis of

hernia in the groin and incompetence of the pouch
of Douglas and pelvic oor. Acta Radiologica. Supplementum 361: 176. PMID 6297246.

It is named after the Scottish anatomist Dr. James Douglas (16751742) who extensively explored this region of
the female body. Three other nearby anatomical structures are also named for him - the Douglas fold, the
Douglas line and the Douglas septum.

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.

Culdotomy

A culdotomy incision or needle puncture of this cul-desac pouch by way of the vagina.
1

10
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): 5404.
doi:10.1067/mob.2000.104836. PMID 10739505.
Ostr AG, Nirenberg A, Ashdown ML, Murphy DJ
(June 1994). Extragenital adenosarcoma arising in
the pouch of Douglas. Gynecologic Oncology 53
(3): 3735. doi:10.1006/gyno.1994.1151. PMID
8206414.

10

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
Douglas Pouch at the US National Library of
Medicine Medical Subject Headings (MeSH)
peritoneum at The Anatomy Lesson by Wesley Norman (Georgetown University)
gures/chapter_35/35-8.HTM Basic Human
Anatomy at Dartmouth Medical School
Anatomy diagram: 03281.000-2 at Roche Lexicon
- illustrated navigator, Elsevier

EXTERNAL LINKS

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Text

Recto-uterine pouch Source: https://en.wikipedia.org/wiki/Recto-uterine_pouch?oldid=692834910 Contributors: Alex.tan, Julesd, Rich

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