Reproductive system · Pelvis · Female
Vesicouterine pouch !
The vesicouterine pouch is the shallow fold of peritoneum between the bladder and the front of the uterus; it is opened in a caesarean section.
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What it is
The shallow peritoneal pocket between the bladder and the front of the uterus.
What it does
Opened in a caesarean section and a hysterectomy to move the bladder down out of the way.
Key facts
- Where
- Shallow peritoneal recess between the bladder and the anterior surface of the uterus (at the isthmus)
- Function
- Opened to create the bladder flap in caesarean section and hysterectomy
Relations
- In front
- Upper surface of the urinary bladder
- Behind
- Front of the uterus at the isthmus and lower uterine segment
- Lateral
- Continues onto the front leaf of the broad ligament, near the round ligament of uterus
- Below
- Vesicocervical space, then the pubocervical fascia between the bladder and the anterior vaginal wall
How to find it
On transabdominal or transvaginal ultrasound it lies between the bladder dome and the front of the uterus. At laparoscopy it is the fold of peritoneum lifted when the uterus is pushed backwards.
On imaging
Usually collapsed and empty on ultrasound and MRI, between the bladder and the front of the uterus. Free fluid collects here less often than in the rectouterine pouch. After a caesarean section, ultrasound looks in this space for a bladder flap haematoma. MRI shows endometriosis nodules or adhesions here, which can pull the uterus forward or involve the bladder wall.
Common problems
- Weakened supports allow prolapse.
- Endometriosis often grows on the uterosacral ligaments.
How it is diagnosed
Examination and ultrasound; seen directly in laparoscopy.
Treatment
- They are divided step by step in a hysterectomy.
Clinical notes
- Anterior colpotomy in vaginal hysterectomy enters the peritoneal cavity through this pouch
- After caesarean section, scarring can obliterate it and draw the bladder up over the lower uterine segment, raising the risk of bladder injury at repeat surgery
- A blood collection between the bladder and the uterine scar after caesarean (bladder flap haematoma) is seen on ultrasound at this site
- Endometriosis here can infiltrate the bladder wall
- In placenta accreta spectrum, placental tissue can extend through the lower segment into this space towards the bladder
Test yourself
Think of the answer, then tap the question to see it.
Why is the vesicouterine pouch shallow and usually empty?
The anteverted uterus lies on the bladder; the pouch is shallower than the rectouterine pouch.
What is the male equivalent of the vesicouterine pouch?
There is none; in men the peritoneum passes from the bladder straight to the rectum, forming the rectovesical pouch.
Why does a previous caesarean section raise the risk of bladder injury at repeat surgery?
Scarring can obliterate the vesicouterine pouch and draw the bladder up over the lower uterine segment.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- excavatio vesicouterina TA2 3724
- Official Spanish (DeCS)
- Excavación vesicouterina
- English (TA2)
- Vesicouterine pouch
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Female Internal Genitals; Anatomy, Abdomen and Pelvis: Female Pelvic Cavity; Anatomy, Abdomen and Pelvis, Peritoneum.
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Representative model, for educational purposes only.
