Surgical significance of the rectovaginal septum

Gross and microscopic studies of 262 patients have shown that there is a definite rectovaginal septum in women which is probably the homologue of the rectovesical fascia of Denonvilliers in the man. The septum is difficult to demonstrate by histologic methods alone because it is adherent to the posterior vaginal wall. During posterior colporrhaphy, immediately following vaginal hysterectomy, the finger dissecting between the vagina and rectum will come upon a thin but strong membrane at the vaginal vault preventing the finger from proceeding into the rectouterine pouch of Douglas. This is the rectovaginal septum and evidence for its existence and a detailed description of its anatomic nature are given. Significant use is made of this tissue in the Bullard-Goff posterior colporrhaphy. This technique is described.