["Spontaneous perforation" of Douglas' pouch]

"Spontaneous" perforations of Douglas's pouch are a rare complication following gynecological surgery. Three patients are reported, in which Wertheim-Meigs-operation, abdominal and vaginal hysterectomy had been performed. Laceration of the vaginal vault with opening of Douglas's pouch occurred "spontaneously" at sexual intercourse. In another patient rupture of the pelvic floor with prolapse of the intestinum was observed 7 months after colpocleisis. Small perforations may be closed through the vagina; prolapse of the intestinum requires laparotomy.