Observations on the anatomy of the rectovaginal pouch and septum

Forty-four women were examined to assess the incidence of rectocele and enterocele in asymptomatic patients, to establish a normal range for the dimensions of the rectovaginal pouch and septum in nulliparas, and to ascertain the effect of parturition on these measurements. The relationship between the depth of the rectovaginal pouch and the presence of enterocele was also studied. Seventeen patients (38%) had rectocele and/or enterocele. In nulliparas the mean depth of the rectovaginal pouch was 5.3 cm and the mean length of the rectovaginal septum was 2.1 cm. Neither parturition nor prolapse altered the depth of the rectovaginal pouch, but parity was associated with an increase in the length of the rectovaginal septum. There was no relationship between the depth of the rectovaginal pouch and the presence of enterocele.