[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Pelvis · Male](https://durgical.com/en/anatomy/region/pelvis/) › Rectovesical pouch [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Pelvis · Male](https://durgical.com/en/anatomy/region/pelvis/) # Rectovesical pouch The rectovesical pouch is the space between the bladder and the rectum in men, the lowest point of the [abdomen](https://durgical.com/en/anatomy/region/abdomen/); fluid, blood or pus collects here first. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=pelvis&variant=male&select=rectovesical_pouch&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The lowest point of the male peritoneal cavity: a fold of peritoneum between the bladder (with the seminal vesicles) and the rectum. ## What it does Fluid, blood or pus in the abdomen collects here first, so it is checked on ultrasound; cancer deposits can settle here and may be felt on a rectal examination. ## Key points - A pelvic abscess here (after appendicitis or a perforation) can cause rectal fullness, mucus diarrhoea and a tender bulge felt on rectal examination - Such abscesses can be drained through the rectal wall or under imaging guidance - Its floor lies above the prostate, near the upper reach of the finger on rectal examination ## Key facts **Where** Lowest point of the male peritoneal cavity, between the rectum behind and the bladder and seminal vesicles in front; male counterpart of the [rectouterine pouch](https://durgical.com/en/anatomy/rectouterine-pouch/) **Attaches** Peritoneum reflected from the front of the upper rectum onto the back of the bladder and the tips of the seminal vesicles; below it, the rectoprostatic (Denonvilliers) fascia **Function** Collects free fluid, blood or pus (pelvic abscess), checked on FAST ultrasound; drop metastases here form a shelf (Blumer) felt on rectal examination ## Relations **In front** [Urinary bladder](https://durgical.com/en/anatomy/urinary-bladder/) and the tips of the [seminal vesicles](https://durgical.com/en/anatomy/seminal-gland/) and ampullae of the [ductus deferens](https://durgical.com/en/anatomy/ductus-deferens/) **Behind** Upper and middle [rectum](https://durgical.com/en/anatomy/rectum/) **Lateral** Peritoneal folds running back from the bladder to the sides of the rectum (rectovesical folds) **Below** Rectoprostatic (Denonvilliers) fascia, between the rectum and the [prostate](https://durgical.com/en/anatomy/prostate/) and seminal vesicles below the [peritoneum](https://durgical.com/en/anatomy/peritoneum/) **Contents** Normally loops of small bowel or [sigmoid colon](https://durgical.com/en/anatomy/sigmoid-colon/); in disease, fluid, blood, pus or tumour deposits ## How to find it On digital rectal examination its floor lies at the upper reach of the finger, above the prostate; tenderness or a mass there may reflect an abscess or deposits. ## On imaging On ultrasound through a full bladder or on CT, free fluid appears behind the bladder first; CT and MRI show pelvic abscesses and peritoneal deposits here. ## How it is diagnosed Ultrasound or CT scan. ## Clinical notes - Some laparoscopic prostatectomy techniques open the peritoneum here first to reach the seminal vesicles from behind - It is the lowest part of the peritoneal cavity in an upright man, so blood or fluid from the abdomen pools here; the pelvic view of a FAST scan looks for it behind the bladder - Peritoneal metastases, for example from [stomach](https://durgical.com/en/anatomy/stomach/) cancer, can settle here and be felt on rectal examination as a hard shelf above the prostate (Blumer shelf) ## Test yourself Think of the answer, then tap the question to see it. ## What is the lowest point of the male peritoneal cavity? The rectovesical pouch, between the rectum and the bladder with the seminal vesicles; male counterpart of the rectouterine pouch. ## How does a pelvic abscess in the rectovesical pouch present? Rectal fullness, mucus diarrhoea and a tender bulge felt on rectal examination; it can be drained through the rectal wall or under imaging. ## What is a Blumer shelf in the male? Drop metastases in the rectovesical pouch forming a shelf felt on rectal examination, above the prostate. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/rectovesical-pouch/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** excavatio rectovesicalis **Official Spanish (DeCS)** Fondo de saco rectovesical **English (TA2)** Rectovesical pouch ## Related - [Urinary bladder](https://durgical.com/en/anatomy/urinary-bladder/) - [Rectum](https://durgical.com/en/anatomy/rectum/) - [Seminal vesicles](https://durgical.com/en/anatomy/seminal-gland/) Sources: [Anatomy, Abdomen and Pelvis, Rectum](https://www.ncbi.nlm.nih.gov/books/NBK537245/); [Anatomy, Abdomen and Pelvis, Peritoneum](https://www.ncbi.nlm.nih.gov/books/NBK534788/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/rectovesical-pouch/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/rectovesical-pouch/