General
Information
DEFINITION--Piercing the "cul-de-sac," the space deep in the vagina
behind and under the cervix.
BODY PARTS INVOLVED--Vagina; lowest part of pelvis behind the uterus and cervix.
REASONS FOR SURGERY--Investigation of possible ailments in the abdomen and
pelvis, including: bleeding inside the lower pelvic cavity; ruptured ectopic pregnancy;
ruptured ovarian cyst; ovarian cancer; or pelvic inflammatory disease. Laboratory
examination of the removed fluid aids in diagnosis.
SURGICAL RISK INCREASES WITH--Recent or chronic illness.
What To Expect
WHO OPERATES--Obstetrician-gynecologist, general surgeon or family doctor.
WHERE PERFORMED--Doctor's office; outpatient surgical facility; or hospital.
DIAGNOSTIC TESTS
- Before surgery: Pap smear; vaginal and abdominal exam; x-rays of lower abdomen.
- After surgery: Laboratory examination of removed fluid.
ANESTHESIA--Local anesthesia by injection.
DESCRIPTION OF OPERATION
- A speculum is inserted into the vagina to hold it open.
- The rear lip of the cervix is raised.
- A local anesthetic is applied to the farthest back portion of the vagina (cul-de-sac).
- The posterior wall of the vagina is penetrated with a needle and syringe.
- Fluid, if present, is aspirated. No sutures are necessary.
POSSIBLE COMPLICATIONS
- Perforation of bladder or bowel (rare).
- Excessive bleeding.
- Surgical-wound infection.
AVERAGE HOSPITAL STAY--Usually none.
PROBABLE OUTCOME
- A fluid sample is obtained successfully without complications in virtually all cases. If
fluid or blood confirms other findings that suggest a serious disease or condition, you
may need further surgery.
- If no fluid is obtained and there are no complications, but you still have your original
symptoms, expect further observation or tests to diagnose your conditions.
- Allow about 1 week for recovery from the procedure.
Postoperative Care
> Continue to use your usual birth--
> You may use non--prescription drugs, such as acetaminophen, to relieve
minor pain.
ACTIVITY---Resume normal activities gradually. Resume sexual relations when
able. This will depend on various underlying causes. Ask your doctor.
DIET---No special diet.
Call Your Doctor If
> You experience vaginal bleeding that soaks more than 1 pad or tampon each hour.
- Symptoms recur or worsen.
