|Latin||excavatio rectouterina, cavum douglassi, fossa douglasi|
The recto-uterine pouch, also known by vaginal fornix and 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.
In women, the recto-uterine pouch is the deepest point of the peritoneal cavity. It lies posterior to the uterus and anterior to 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.
The recto-uterine 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.
A culdotomy or posterior colpotomy is an incision or needle puncture into this "cul-de-sac" pouch by way of the vagina.
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 commonly referred to as the pouch of Douglas or the posterior cul-de-sac.
The Douglas fold (rectouterine plica), Douglas line, and Douglas septum are likewise named after the same James Douglas.
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