Concepts of the rectovaginal septum: implications for function and surgery

Area of Science:

• Anatomy
• Surgical Anatomy
• Pelvic Anatomy

Background:

• The rectogenital septum (RGS) separates pelvic compartments, with its existence debated in women.
• In men, it's known as Denonvilliers' fascia (rectovesical septum, RVS).

Purpose of the Study:

• To update knowledge on the RGS in women.
• To clarify its relationship with pelvic nerves.
• To deduce surgical implications and compare it to the male RVS.

Main Methods:

• A comprehensive review of anatomical and surgical literature.
• Examined evidence for embryological origin, composition, and surgical importance.

Main Results:

• Confirmed the existence of the RGS in women (rectovaginal septum, RVaS) and men (RVS).
• The RGS originates from genital structures, extending to the perineal body, containing connective tissue and smooth muscle.
• It closely contacts pelvic neurovascular bundles, making it a vital landmark for nerve-sparing surgery.

Conclusions:

• The rectogenital septum is present in both sexes with significant similarities.
• It is a crucial surgical landmark for pelvic nerve preservation during various procedures.