Culdocentesis

Last updated
Culdocentesis
WeiblichesBeckenMedian.gif
Sagittal section of the lower part of a female trunk, right segment. (Pouch of Douglas labeled at bottom right.)
Specialty gynaecology
ICD-9-CM 70.0
MedlinePlus 003919

Culdocentesis is a medical procedure involving the extraction of fluid from the rectouterine pouch (pouch of Douglas) [1] posterior to the vagina through a needle. It can be one diagnostic technique used in identifying pelvic inflammatory disease (in which case purulent fluid will be extracted) and ruptured ectopic pregnancies that cause hemoperitoneum. [2]

Contents

In the procedure, the rectouterine pouch is often reached through the posterior fornix of the vagina. The process of creating the hole is called colpotomy if a scalpel incision is made to drain the fluid rather than using a needle.

See also

Related Research Articles

<span class="mw-page-title-main">Bartholin's gland</span> Mucous glands located near the vaginal opening

The Bartholin's glands are two pea-sized compound alveolar glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina.

<span class="mw-page-title-main">Transdermal implant</span>

Transdermal implants, or dermal piercings, are a form of body modification used both in a medical and aesthetic context that, in contrast to subdermal implants, consist of an object placed partially below and partially above the skin, thus implanted transdermal. Two techniques are prevalent using post-like and microdermal implants respectively.

Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplasty is needed following the treatment or removal of malignant growths or abscesses to restore a normal vaginal structure and function. Surgery to the vagina is done to correct congenital defects to the vagina, urethra and rectum. It may correct protrusion of the urinary bladder into the vagina (cystocele) and protrusion of the rectum (rectocele) into the vagina. Often, a vaginoplasty is performed to repair the vagina and its attached structures due to trauma or injury.

<span class="mw-page-title-main">Rectouterine pouch</span> Human female anatomical structure

The rectouterine pouch is the extension of the peritoneum into the space between the posterior wall of the uterus and the rectum in the human female.

<span class="mw-page-title-main">Paracentesis</span> Form of body fluid sampling procedure

Paracentesis is a form of body fluid sampling procedure, generally referring to peritoneocentesis in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid.

ICD-9-CM Volume 3 is a system of procedural codes used by health insurers to classify medical procedures for billing purposes. It is a subset of the International Statistical Classification of Diseases and Related Health Problems (ICD) 9-CM. Volumes 1 and 2 are used for diagnostic codes.

<span class="mw-page-title-main">Lumen (anatomy)</span> Cavity within an organ

In biology, a lumen is the inside space of a tubular structure, such as an artery or intestine. It comes from Latin lumen 'an opening'.

<span class="mw-page-title-main">Natural orifice transluminal endoscopic surgery</span>

Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice then through an internal incision in the stomach, vagina, bladder or colon, thus avoiding any external incisions or scars. Memic's hominis robotic system is the first and only FDA-authorized surgical robotic platform for NOTES procedures. The system is currently at use for transvaginal hysterectomies through the rectouterine pouch - the removal of the uterus, along with one or both of the fallopian tubes and ovaries, in cases where there is no cancer present, as well as with the removal of ovarian cysts

<span class="mw-page-title-main">Rectouterine fold</span>

The rectouterine fold is a bilaterally paired prominent ridge/fold of the peritoneum that represents the lateral boundary of the rectouterine pouch on either side. It is formed by the underlying rectouterine muscle. On either side, the rectouterine fold extends between the sacrum medially, and the base of the broad ligament of the uterus laterally.

<span class="mw-page-title-main">Vesicouterine pouch</span> Fold of peritoneum in human female anatomy

In human female anatomy, the vesicouterine pouch, also uterovesicle pouch, is a fold of peritoneum over the uterus and the bladder. Like the rectouterine pouch, it is a female pelvic recess, but shallower and closer to the anterior fornix of the vagina.

<span class="mw-page-title-main">Retropubic space</span>

Retropubic space is a potential avascular space located between the pubic symphysis and the urinary bladder. The retropubic space is a preperitoneal space, located behind the transversalis fascia and in front of peritoneum.

<span class="mw-page-title-main">Rectovesical pouch</span> Part of pelvic anatomy in male mammals

The rectovesical pouch is the pocket that lies between the rectum and the bladder in males in humans and other mammals. It is lined by peritoneum.

The extraperitoneal space is the portion of the abdomen and pelvis which does not lie within the peritoneum.

<span class="mw-page-title-main">Uterosacral ligament</span>

The uterosacral ligaments are major ligaments of uterus that extend posterior-ward from the cervix to attach onto the sacrum.

<span class="mw-page-title-main">Pelvic examination</span> Physical medical examination

A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, discharge, urinary incontinence, or trauma. It can also be used to assess a woman's anatomy in preparation for procedures. The exam can be done awake in the clinic and emergency department, or under anesthesia in the operating room. The most commonly performed components of the exam are 1) the external exam, to evaluate the vulva 2) the internal exam with palpation to examine the uterus, ovaries, and structures adjacent to the uterus (adnexae) and 3) the internal exam using a speculum to visualize the vaginal walls and cervix. During the pelvic exam, sample of cells and fluids may be collected to screen for sexually transmitted infections or cancer.

Culdoscope is an instrument, a kind of endoscope, used to visualize female pelvic organs, introduced through the vagina into the cul-de-sac. The procedure of inserting the culdoscope into the rectouterine pouch is termed culdoscopy.

<span class="mw-page-title-main">Culdoscopy</span> Medical procedure

Culdoscopy is an endoscopic procedure performed to examine the rectouterine pouch and pelvic viscera by the introduction of a culdoscope through the posterior vaginal wall. The word culdoscopy is derived from the term cul-de-sac, which means literally in French "bottom of a sac", and refers to the rectouterine pouch.

A Dolichodouglas is the medical term describing an abnormally profound Douglas' pouch. It may be congenital or acquired. The increased depth of the Douglas' pouch brings it in close anatomical contact with the posterior vaginal wall. Therefore, intestinal loops may apply pressure to this wall, causing a condition known as enterocele, which presents as an outpouching on the posterior vaginal wall. This can be felt and seen during pelvic exam.

<span class="mw-page-title-main">Sampling (medicine)</span> Collection of bodily substances for medical assessment

In medicine, sampling is gathering of matter from the body to aid in the process of a medical diagnosis and/or evaluation of an indication for treatment, further medical tests or other procedures. In this sense, the sample is the gathered matter, and the sampling tool or sampler is the person or material to collect the sample.

References

  1. "culdocentesis" at Dorland's Medical Dictionary
  2. "Culdocentesis: Overview, Indications, Contraindications". 2019-11-09.