If you’ve ever had an ultrasound, you may have seen fluid in the cul-de-sac area. The pouch is located just behind the vagina.
This article explains why fluid sometimes collects there and how your health care provider diagnoses why.
anatomy
There are two small pouches on each side of the uterus. These are called dead ends. The anterior capsule is the space between the bladder and the uterus. The posterior capsule is located between the uterus and rectum. This latter cul-de-sac is named after the Scottish physician James Douglas and is also known as Douglas’ Bag.
Do people with penises have Douglas bags?
yes. It is known as the rectovesical pouch. It is located between the rectum and the bladder.
Very Well / Jessica Oler
What causes body fluid to collect in the bag?
Body fluids can fill the cul-de-sac for a variety of reasons. When an ovarian cyst or follicle ruptures, fluid may leak. In some cases, more serious problems may occur. Possible causes are:
- Ectopic pregnancy, a condition in which the pregnancy grows in the fallopian tubes instead of the uterus
- Endometriosis, which occurs when tissue that normally lines the uterus grows elsewhere.
- Continue bone punctureSteps to remove liquid from pouch
- Ascites (accumulation of fluid in the abdomen)
- Hydatidiform molealso called molar pregnancy, involves the formation of a cyst from a fertilized egg.
- High doses of estrogen causing fluid to leak from blood vessels
- Ovarian torsion, a condition in which the fallopian tubes and ovaries become twisted
- Pelvic abscess or hematoma, a pocket of infected fluid or blood
- pelvic inflammatory disease
- Retrograde menstruation occurs when menstrual fluid flows backward into the pelvis.
- tubo-ovarian abscess, a pus-filled area within the ovary and fallopian tubes
- Uterine fibroids, non-cancerous growths in the uterus
- Tears or breaks in the uterine wall
infertility treatment
If you are undergoing fertility treatment, fluid in the pouch may be a symptom of ovarian hyperstimulation syndrome (OHSS). OHSS is a condition in which the ovaries become swollen due to high doses of fertility hormones.
If your health care provider suspects you have OHSS, he or she may recommend an ultrasound to check for body fluids. The ovaries can be measured during an ultrasound examination.
Liquid in the bag is usually nothing to worry about. However, in some cases, it can cause discomfort or affect fertility.
How is fluid in the sac vesicle diagnosed?
Fluid in the sac is diagnosed by performing a transvaginal ultrasound.a bone puncture may also be performed.
Transvaginal ultrasound examination
A transvaginal ultrasound can show if there is fluid behind the uterus. A wand is inserted into the vagina to take more detailed ultrasound images. If fluid is found and there is pain, further tests may be needed.
bone puncture
Before transvaginal ultrasound became widely available, this procedure was used to check for fluid in this area. Nowadays, it is mainly used to collect liquid samples for testing.
A vaginal puncture involves inserting a needle into the vaginal wall to collect a sample of body fluids. Painkillers or anesthesia are often used. The health care provider uses an instrument to hold the cervix in place so that the needle is inserted in the correct place.
It is normal for there to be a small amount of liquid in the bag. However, if the sample shows signs of pus or blood, the area may need to be drained.
If there is blood in the fluid, the cyst may have ruptured or split. It may also be a sign of an ectopic pregnancy. If there is pus, you may have an infection.
How is fluid removed from the sac?
Using a very thin needle inserted through the vaginal wall, fluid is removed for testing. If the test is abnormal, a bone tap is done to remove the fluid. If there is pus in your body fluids, your health care provider may prescribe antibiotics for the infection.
summary
On each side of the uterus are two small sacs called sacs. Liquid may collect within these pouches. It’s normal to have a small amount of fluid, but if it contains pus or blood or is causing pain, there may be a larger health problem.
It may be caused by an infection, pregnancy complications, or a health condition such as endometriosis or uterine fibroids. It is also possible that the cyst, follicle, or uterus itself has ruptured. In some cases, infertility treatments can result in excess fluid.
Liquids can usually be detected using ultrasound. In some cases, a bone puncture, in which a sample of fluid is removed with a needle and examined, may also be necessary. Depending on the cause, fluid may need to be drained or treatment with antibiotics may be necessary.