Space
Vesicouterine pouch
The anterior pelvic peritoneal reflection
High-yield
Separate the peritoneal recess from the tissue plane beneath it: the vesicouterine pouch opens into the peritoneal cavity, while the lower vesicocervical plane lies outside that cavity.
Overview
Peritoneum passing from the bladder onto the anterior uterus creates the vesicouterine recess. It is usually shallower than the rectouterine pouch, and its shape changes with bladder filling and uterine position. Below the reflection, bladder and lower uterine tissues are related through an extraperitoneal connective-tissue plane.
Reference facts
- Boundaries
- The superior bladder surface lies anterior to the recess and the anterior uterine surface behind it; the peritoneum turns between them near the lower uterine region.
- Contents
- It is a potential recess with a lubricating film and variable room for fluid or adjacent bowel, depending on pelvic organ position.
- Communications
- It joins the general peritoneal cavity superiorly. The connective-tissue plane below the reflection extends toward the cervix and anterior vagina without forming an open continuation of the peritoneal pouch.
Clinical correlation
Adhesions after pelvic surgery can tether the bladder to the lower uterus and distort this normally mobile relationship. Prior cesarean delivery and adhesions are associated with bladder injury in subsequent operations. Creation of a bladder flap is a surgical technique, not an anatomical step required in every cesarean delivery.
Frequently asked questions
What are the boundaries of the vesicouterine pouch?
The superior bladder surface lies anterior to the recess and the anterior uterine surface behind it; the peritoneum turns between them near the lower uterine region.
What does the vesicouterine pouch contain?
It is a potential recess with a lubricating film and variable room for fluid or adjacent bowel, depending on pelvic organ position.
What does the vesicouterine pouch communicate with?
It joins the general peritoneal cavity superiorly. The connective-tissue plane below the reflection extends toward the cervix and anterior vagina without forming an open continuation of the peritoneal pouch.