| Recto-uterine 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.) | |
| Latin | excavatio rectouterina, cavum douglassi, fossa douglasi |
| Gray's | subject #246 1152 |
| MeSH | Douglas'+Pouch |
The rectouterine pouch (or rectouterine excavation, rectovaginal, Ehrhardt-Cole Recess or Pouch of Douglas) is the extension of the peritoneal cavity between the rectum and back wall of the uterus in the female human body.
The rectouterine 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.
In women it is the deepest point of the peritoneal cavity, posterior to (behind) the uterus and anterior to (in front of) rectum. (The pouch on the other side of the uterus is the vesicouterine excavation.)
It is near the posterior fornix of the vagina.
In men, the region corresponding to the rectouterine pouch is the rectovesical excavation, which lies between the urinary bladder and rectum. (There is no equivalent to the vesicouterine excavation.)
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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.
It is also known by the names Douglas pouch, Douglas cavity, Douglas space and Douglas cul-de-sac.[1]
It is named after the Scottish anatomist Dr. James Douglas (1675–1742) 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.
It is thought by some that when a woman becomes aroused, her uterus will retract, making it possible for the rectouterine pouch to be stimulated through the end of the posterior wall of the vagina, which could result in an intense orgasm. It may also be stimulated through the anterior wall of the anus. In a sexual context, the rectouterine pouch is referred to as the epicenter, backstop or deep spot (in common with the AFE zone), the PFE zone (posterior fornix erogenous zone) or, most commonly, the cul-de-sac.
A culdotomy incision or needle puncture of this "cul-de-sac" pouch by way of the vagina.
As it is the furthest-most point of the abdominopelvic cavity in women, it is a site where infection and fluids typically collect[2] .
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