Sigmoidocele (also known as

Pouch of Douglas The rectouterine pouch (recto-uterine pouch), pouch of Douglas, or rectovaginal pouch is the extension of the peritoneum between the rectum and the posterior wall of the uterus in the human female. Its anterior boundary is formed by the posterior ...

descent) refers to a condition where the

sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...

descends (prolapses) into the

lower pelvic Lower may refer to: *Lower (surname) *Lower Township, New Jersey *Lower Receiver (firearms) *Lower Wick Gloucestershire, England See also *Nizhny Nizhny (russian: Ни́жний; masculine), Nizhnyaya (; feminine), or Nizhneye (russian: Ни́� ...

cavity. This can obstruct the rectum and cause symptoms of obstructed defecation.

Pathophysiology

The phenomenon is caused by a weak section of fascial supports of the vagina (the uterosacral cardinal ligament complex and rectal vaginal septum), which allows a section of peritoneum containing the sigmoid colon to prolapse out of normal position and fall between the rectum and the vagina.

Diagnosis

It is not possible to differentiate between a

rectocele In gynecology, a rectocele ( ) or posterior vaginal wall prolapse results when the rectum bulges ( herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of pel ...

and a sigmoidocele on

vaginal examination The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), cervical smear (BE), cervical screening (BE), or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in ...

. Defecating proctography will demonstrate a sigmoidocele during straining.

Epidemiology

Sigmoidocele normally occurs in females, and is uncommon.

References

{{Female diseases of the pelvis and genitals Noninflammatory disorders of female genital tract Colorectal surgery Gynaecology