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Culdocentesis

 

Culdocentesis is a procedure that checks for abnormal fluid in the space just behind the vagina. This area is called the cul-de-sac.

How the Test is Performed

First, you will have a pelvic exam. Then, the health care provider will hold the cervix with an instrument and lift it slightly.

A long, thin needle is inserted through the wall of the vagina (just below the uterus). A sample is taken of any fluid found in the space. The needle is pulled out.

How to Prepare for the Test

 

You may be asked to walk or sit for a short time before the test is done.

 

How the Test will Feel

 

You may have an uncomfortable, cramping feeling. You will feel a brief, sharp pain as the needle is inserted.

 

Why the Test is Performed

 

This procedure is rarely done today because a transvaginal ultrasound can show fluid behind the uterus.

It may be done when:

  • You have pain in the lower abdomen and pelvis, and other tests suggest there is fluid in the area.
  • You may have a ruptured ectopic pregnancy or ovarian cyst.

 

Normal Results

 

No fluid in the cul-de-sac, or a very small amount of clear fluid, is normal.

 

What Abnormal Results Mean

 

Fluid may still be present, even if not seen with this test. You may need other tests.

A sample of fluid may be taken and tested for infection.

If blood is seen in the area, you may need emergency surgery.

 

Risks

 

Risks include puncturing the uterine or bowel wall.

 

Considerations

 

You may need someone to take you home if you were given medicines to relax.

 

 

References

Braen GR. Culdocentesis In: Roberts JR, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 57.

Eisinger SH. Culdocentesis (colpocentesis). In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 139.

 
  • Female reproductive anatomy

    Female reproductive anatomy - illustration

    External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

    Female reproductive anatomy

    illustration

  • Culdocentesis

    Culdocentesis - illustration

    During a culdocentesis a long thin needle is inserted through the vaginal wall just below the uterus and a sample is taken of the fluid within the abdominal cavity.

    Culdocentesis

    illustration

  • Cervix needle sample

    Cervix needle sample - illustration

    Culdocentesis is a procedure which checks for abnormal fluid in the space that is just behind the vagina, the posterior cul-de-sac. This procedure is done when pain occurs in the lower abdomen and pelvic regions, and other tests suggest that fluid may be present in the cul-de-sac. The test may also be done when a ruptured ectopic pregnancy or ovarian cyst is suspected.

    Cervix needle sample

    illustration

    • Female reproductive anatomy

      Female reproductive anatomy - illustration

      External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

      Female reproductive anatomy

      illustration

    • Culdocentesis

      Culdocentesis - illustration

      During a culdocentesis a long thin needle is inserted through the vaginal wall just below the uterus and a sample is taken of the fluid within the abdominal cavity.

      Culdocentesis

      illustration

    • Cervix needle sample

      Cervix needle sample - illustration

      Culdocentesis is a procedure which checks for abnormal fluid in the space that is just behind the vagina, the posterior cul-de-sac. This procedure is done when pain occurs in the lower abdomen and pelvic regions, and other tests suggest that fluid may be present in the cul-de-sac. The test may also be done when a ruptured ectopic pregnancy or ovarian cyst is suspected.

      Cervix needle sample

      illustration

    Tests for Culdocentesis

     

     

    Review Date: 4/5/2016

    Reviewed By: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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