The rectouterine pouch (rectovaginal pouch, pouch of Douglas or cul-de-sac) is the extension of the peritoneum into the space between the posterior wall of the uterus and the rectum in the human female.

Structure

In women, the rectouterine pouch is the deepest point of the peritoneal cavity. It is posterior to the uterus, and anterior to the rectum. Its anterior boundary is formed by the posterior fornix of the vagina.

In men, the region corresponding to the rectouterine pouch is the rectovesical pouch, which lies between the urinary bladder and rectum.

Peritoneal fluid

It is normal to have approximately 1 to 3 ml (or mL) of fluid in the rectouterine pouch throughout the menstrual cycle. After ovulation there is between 4 and 5 ml of fluid in the rectouterine pouch.

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, Douglas cavity,

The Douglas fold (rectouterine plica), Douglas line, and Douglas septum are likewise named after the same James Douglas.

The Pouch of Douglas was featured in the Netflix special Hannah Gadsby: Douglas to deconstruct patriarchy.

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

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File:Gray1035.png|The epiploic foramen, greater sac or general cavity (red) and lesser sac, or omental bursa (blue).

File:Illu female pelvis.jpg|Illu female pelvis

</gallery>

See also

  • Vesicouterine pouch
  • Rectovesical pouch
  • Retropubic space

References

Further reading

  • - "The Female Pelvis: Distribution of the Peritoneum in the Female Pelvis"