Anatomy
The Douglas space, anatomically also called “Excavatio rectouterina”, refers to a small cavity in the woman’s lower pelvis. As the Latin technical term suggests, the space is located between the uterus and the rectum, the last section of the colon. In men, due to the absence of the uterus, the space extends to the bladder and is therefore not called the Douglas space but the “Proust space”.
The space is still inside the abdominal cavity, surrounded by peritoneum, the so-called “peritoneum”. In humans it represents the deepest point of the peritoneal cavity. The space is bounded from below by the peritoneum, from the front by the uterus and the upper sections of the vagina and from behind by the rectum.
The Douglas cavity is open upwards to the abdominal cavity with its intestinal loops and abdominal organs, which extends to the diaphragm. For this reason, the Douglas cavity can be involved in all pathological changes of the abdominal cavity, while at the same time being in close spatial relation to the vagina and the uterus. The Douglas cavity does not have a function of its own for the body, it is merely an anatomical feature. Due to its location as the deepest point of the abdominal cavity, it is often affected by malignant and inflammatory processes.
Anatomical differences between men and women
In women, the Douglas space describes the gap between the rectum and the uterus and is the deepest point of the abdominal cavity when standing. In Latin it is therefore also called Excavatio rectouterina (“rectum-uterine cavity”). The bladder is located in front of the uterus.
Between the uterus and the bladder there is a further pocket-shaped depression called the excavatio vesicouterina (“bladder – rectum – cavity”). The Douglas cavity is the clinical colloquial term for the deepest point of a woman’s abdominal cavity when standing and is also known in medical terminology as the Excavatio rectouterina. It is located between the uterus and the rectum and is a depression that can extend to the back of the vagina.
A man, of course, also has a deepest point of the abdominal cavity when standing – but this is not called the Douglas space but the Proust space. In medical terminology, it is also called Excavatio rectovesicalis. The Proust space is located between the male bladder and the rectum.
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