The Rectovaginal Septum

Abstract

The ventral part of the rectovaginal septum is formed by a connective tissue layer fixed to the vagina. The dorsal part is the connective tissue of the rectum. The roof is the peritoneum and the rectouterine peritoneal pouch (cul-de-sac of Douglas). The caudal margin is the perineal body. The perineal body (or central tendon of perineum), pyramidal fibromuscular mass, is in the middle line of the perineum at the junction between the urogenital triangleand the anal triangle. At the level of the perineal body, rectovaginal fascia, puborectal muscles, transverse perineal muscles and external anal sphincter are joined. It is a very strong structure. The perineal body is fundamental to the integrity of the pelvic floor. Its rupture during vaginal birth leads to widening of the gap between the anterior free borders of levator animuscle of both sides, thus predisposing the woman to prolapse of the uterus, rectumor even urinary bladder.