Pelvic Spaces

Parietal peritoneum from the abdominal cavity extends into the pelvic cavity and covers portions of pelvic viscera (Fig. 5.25). This draping effect creates a series of peritoneal and subperitoneal recesses. The subperitoneal recesses are filled with endopelvic fascia that creates supportive septa between viscera.

Figure 1:Pelvic spaces. Yellow area represents parietal peritoneum draping over pelvic viscera. A, Male. B, Female. B = bladder, C = cervix, P = prostate, PS = pubic symphysis, R = rectum, U = uterus, V = vagina.
A. Peritoneal recesses
These intraperitoneal spaces are typically filled with small intestinal loops and normal peritoneal fluids.
1. Rectovesical pouch: In the male, this is the space between the bladder and rectum.
2. Vesicouterine pouch: In the female, this is the space between the bladder and uterus.
3. Rectouterine pouch: In the female, this is the space between the uterus and rectum. The inferior limit of this space is located adjacent to the posterior fornix of the vagina.

B. Subperitoneal recesses
These spaces or septa lie inferior to the parietal peritoneum and are filled with endopelvic fascia. They are continuous with the retroperitoneal space in the abdominal cavity.
1. Retropubic space: Known clinically as the space of Retzius, it is located just posterior to the pubic symphysis and anterior to the bladder.
2. Retrorectal space: This space is located anterior to the sacrum (presacral) and posterior to the rectum.
3. Rectovesical septum: Found only in males, this septum is found between the bladder and rectum and extends from the rectovesical pouch to the perineum.
4. Rectovaginal septum: Found only in females, this septum is found between the vagina and rectum and extends from the rectouterine pouch to the perineum.