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Culdocentesis

  • Definition
    • Culdocentesis is a procedure that checks for abnormal fluid in the space just behind the vagina. This area is called the cul-de-sac.

  • How the Test is Performed
    • First, you will have a pelvic exam. Then, the health care provider will hold the cervix with an instrument and lift it slightly.

      A long, thin needle is inserted through the wall of the vagina (just below the uterus). A sample is taken of any fluid found in the space. The needle is pulled out.

  • How to Prepare for the Test
    • You may be asked to walk or sit for a short time before the test is done.

  • How the Test will Feel
    • You may have an uncomfortable, cramping feeling. You will feel a brief, sharp pain as the needle is inserted.

  • Why the Test is Performed
    • This procedure is rarely done today because a transvaginal ultrasound can show fluid behind the uterus.

      It may be done when:

      • You have pain in the lower abdomen and pelvis, and other tests suggest there is fluid in the area.
      • You may have a ruptured ectopic pregnancy or ovarian cyst.
  • Normal Results
    • No fluid in the cul-de-sac, or a very small amount of clear fluid, is normal.

  • What Abnormal Results Mean
    • Fluid may still be present, even if not seen with this test. You may need other tests.

      A sample of fluid may be taken and tested for infection.

      If blood is seen in the area, you may need emergency surgery.

  • Risks
    • Risks include puncturing the uterine or bowel wall.

  • Considerations
    • You may need someone to take you home if you were given medicines to relax.

  • References
    • Braen GR. Culdocentesis In: Roberts JR, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 57.

      Eisinger SH. Culdocentesis (colpocentesis). In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 139.