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.)
|Latin||excavatio rectouterina, cavum douglassi, fossa douglasi|
The recto-uterine pouch, also known by various other names (e.g., pouch of Douglas), is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body.
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.
It is normal to have approximately 1 to 3 ml (or mL) of fluid in the recto-uterine pouch throughout the menstrual cycle. After ovulation there is between 4 and 5 ml of fluid in the recto-uterine pouch.
Naming and etymology
The recto-uterine (or rectouterine) pouch is also called the recto-uterine (or rectouterine) excavation, utero-rectal (or uterorectal) pouch, recto-vaginal (or rectovaginal) pouch, pouch of Douglas (after anatomist James Douglas, 1675–1742), Douglas pouch, Douglas cavity, Douglas space, Douglas cul-de-sac, 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 Gynecology, it is most commonly referred to as the posterior cul-de-sac.
The Douglas fold (rectouterine plica), Douglas line, and Douglas septum are likewise named after the same James Douglas.
A culdotomy or posterior colpotomy is an incision or needle puncture of this "cul-de-sac" pouch by way of the vagina.
The recto-uterine pouch is used in the treatment of end-stage 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.
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- Anatomy photo:43:02-0300 at the SUNY Downstate Medical Center - "The Female Pelvis: Distribution of the Peritoneum in the Female Pelvis"
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