Recto-uterine pouch
Latin excavatio rectouterina, cavum douglassi, fossa douglasi
MeSH A01.047.025.600.225
TA A10.1.02.512
FMA 14728
Anatomical terminology

The recto-uterine pouch, also known by various other names (i.e. Douglas' pouch), is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body.


Structure and physiologyEdit

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) in the recto-uterine pouch throughout the menstrual cycle.[1] After ovulation there is between 4 and 5 ml of fluid in the recto-uterine pouch.[1]

In men, the region corresponding to the recto-uterine pouch is the recto-vesical pouch, which lies between the urinary bladder and rectum. (There is no equivalent to the vesico-uterine pouch).



Naming and etymologyEdit

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,[2] Douglas cavity,[2] Douglas space,[2] Douglas cul-de-sac,[2] 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.[3]

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.

Clinical significanceEdit



Additional imagesEdit

See alsoEdit


  1. ^ a b Severi FM, Bocchi C, Vannuccini S, Petraglia F (2012). "Ovary and ultrasound: from physiology to disease" (PDF). Archives of Perinatal Medicine. 18 (1): 7–19. 
  2. ^ a b c d synd/2937 at Who Named It?
  3. ^ Hensen, Jan-Hein J.; Puylaert, Julien B. C. M. (2009-06-01). "Endometriosis of the Posterior Cul-De-Sac: Clinical Presentation and Findings at Transvaginal Ultrasound". American Journal of Roentgenology. 192 (6): 1618–1624. doi:10.2214/AJR.08.1807. ISSN 0361-803X. 

Further readingEdit

  • Gullmo A (1980). "Herniography. The diagnosis of hernia in the groin and incompetence of the pouch of Douglas and pelvic floor". Acta Radiologica. Supplementum. 361: 1–76. PMID 6297246. 
  • Baessler K, Schuessler B (March 2000). "The depth of the pouch of Douglas in nulliparous and parous women without genital prolapse and in patients with genital prolapse". American Journal of Obstetrics and Gynecology. 182 (3): 540–4. doi:10.1067/mob.2000.104836. PMID 10739505. 
  • Ostör AG, Nirenberg A, Ashdown ML, Murphy DJ (June 1994). "Extragenital adenosarcoma arising in the pouch of Douglas". Gynecologic Oncology. 53 (3): 373–5. doi:10.1006/gyno.1994.1151. PMID 8206414. 

Tsin DA. Culdolaparoscopy: a preliminary report. JSLS. 2001 Jan-Mar;5(1):69-71. PMID 11303998

External linksEdit