Pouch of Douglas
Encyclopedia
The rectouterine pouch 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.)
, tumour, endometriosis
, pus
, etc.
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.
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.
" pouch by way of the vagina.
Peritoneum
The peritoneum is the serous membrane that forms the lining of the abdominal cavity or the coelom — it covers most of the intra-abdominal organs — in amniotes and some invertebrates...
between the rectum
Rectum
The rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...
and back wall of the uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
in the female human body
Human body
The human body is the entire structure of a human organism, and consists of a head, neck, torso, two arms and two legs.By the time the human reaches adulthood, the body consists of close to 100 trillion cells, the basic unit of life...
.
The rectouterine pouch is used in the treatment of end-stage renal failure
Renal failure
Renal failure or kidney failure describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood...
in patients who are treated by peritoneal dialysis
Peritoneal dialysis
Peritoneal dialysis is a treatment for patients with severe chronic kidney disease. The process uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood...
. 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
Vesicouterine excavation
In human female anatomy, the vesicouterine excavation is a second, but shallower, pouch formed from the peritoneum over the uterus and bladder, continued over the intestinal surface and fundus of the uterus onto its vesical surface, which it covers as far as the junction of the body and cervix...
.)
It is near the posterior fornix of the vagina.
In men, the region corresponding to the rectouterine pouch is the rectovesical excavation
Rectovesical excavation
Between the rectum and the bladder the peritoneal cavity forms, in the male, a pouch, the rectovesical excavation , the bottom of which is slightly below the level of the upper ends of the vesiculae seminales—i. e., about 7.5 cm. from the orifice of the anus...
, which lies between the urinary bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...
and rectum. (There is no equivalent to the vesicouterine excavation.)
Pathology
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 ascitesAscites
Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...
, tumour, endometriosis
Endometriosis
Endometriosis is a gynecological medical condition in which cells from the lining of the uterus appear and flourish outside the uterine cavity, most commonly on the ovaries. The uterine cavity is lined by endometrial cells, which are under the influence of female hormones...
, pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...
, etc.
Naming and etymology
It is also known by the names Douglas pouch, Douglas cavity, Douglas space and Douglas cul-de-sac.It is named after the Scottish
Scotland
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
anatomist Dr. James Douglas
James Douglas (physician)
James Douglas was a Scottish physician and anatomist, and Physician Extraordinary to Queen Caroline.One of the seven sons of William Douglas and his wife, Joan, daughter of James Mason of Park, Blantyre, he was born in West Calder, West Lothian, in 1675...
(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.
Sexual response
It is thought by some that when a woman becomes aroused, her uterusUterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
will retract, making it possible for the rectouterine pouch to be stimulated through the end of the posterior wall of the vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
, which could result in an intense orgasm
Orgasm
Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...
. It may also be stimulated through the anterior wall of the anus
Anus
The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...
. In a sexual context, the rectouterine pouch is referred to as the epicenter, backstop or deep spot (in common with the AFE zone
Anterior fornix erogenous zone
The anterior fornix erogenous zone is a female erogenous zone that when stimulated can lead to rapid vaginal lubrication and arousal, sometimes without any other form of stimulation, with continued stimulation resulting in an intense orgasm.-Early research:The AFE...
), the PFE zone (posterior fornix erogenous zone) or, most commonly, the cul-de-sac.
Culdotomy
A culdotomy incision or needle puncture of this "cul-de-sacCul-de-sac
A cul-de-sac is a word of French origin referring to a dead end, close, no through road or court meaning dead-end street with only one inlet/outlet...
" pouch by way of the vagina.