Structure

Liquid in small quantities. Reasons for the appearance of free fluid in the space of Douglas (retrouterine). Fluid in the retrouterine space causes

Well, tell me honestly: wouldn’t you be scared if, during an ultrasound, the doctor reports that you have fluid in the retrouterine space? Any patient will immediately have questions. What kind of substance is this? Should she be there and does her presence indicate illness? How dangerous is this? Let's talk about this problem in more detail.

Female anatomy: where is the pouch of Douglas located and where does the fluid come from?

The retrouterine space (or, as doctors call it, the space of Douglas) is a closed cavity that is located behind the uterus and limited by the peritoneal wall. Free fluid in the retrouterine space collects in the lowest recess of this cavity.

What does it mean if fluid is detected in the retrouterine space? Its presence may be related to physiological reasons- then there is nothing to worry about, it will disappear on its own. But in some cases it still threatens women's health, since its appearance is associated with diseases. If they are not treated in a timely manner, the fluid may penetrate into the peritoneal cavity, which will lead to the development of such a dangerous condition as peritonitis.

There is fluid, but no problem

Nothing “like that” should be found in the cavity of Douglas. However, there are a few cases where a small amount of fluid may still be present in the retrouterine space, and this is completely normal and does not require treatment. The natural processes that occur in a woman’s body are to blame for its accumulation, namely:

cast small portion blood during menstruation (which is completely safe). During menstruation, the endometrium, along with menstrual blood, penetrates into the abdominal cavity;
ovulation. When the capsule of the follicle bursts and the mature egg comes out to meet the sperm, a small part of the fluid that is released can also enter the space behind the uterus. After a couple of days it is absorbed;
period of puberty in girls and young girls.

If the diagnostician saw fluid in the retrouterine space (in a small amount) during an ultrasound examination of the patient, then he does not immediately make a final diagnosis. The doctor watches for some time to see how the situation develops further. If a subsequent ultrasound reveals that the fluid has resolved, this indicates that everything is “going according to plan”: ovulation has completed normally.

If illness is to blame: pathological causes of fluid accumulation

All of the above cases, which lead to the appearance of fluid in the retrouterine space, do not require medical intervention. The causes associated with diseases should be treated completely differently. Of course, fluid is only a symptom and may be a sign of the following health problems:

inflammation in the uterus. His characteristic symptoms - low-grade fever, pain in the lower abdomen, serous-purulent discharge. Antibiotics will be prescribed for treatment. Symptomatic therapy carried out using painkillers and restoratives;
polyps on the uterus. The symptoms of this pathology are prolonged and heavy menstruation, bleeding between periods, pain during sexual intercourse, bloody issues after sex, problems with conception. Treatment can be done with hormones, or the polyp can be removed hysteroscopically;
diseases of organs located adjacent to the uterus. So, with pelvioperitonitis, peritoneal fluid appears in the space behind the uterus. A diseased liver can provoke its appearance. This also happens with heart or kidney failure. The organs in which the inflammatory process has begun release exudate - it “finds” free space and fills it. Treatment depends on the diagnosis;
apoplexy (rupture) of the ovary. Leading symptoms - sharp pain and bleeding. Weakness occurs, blood pressure drops, temperature rises, it happens one-time vomiting. Surgical treatment (laparoscopy);
endometriotic cyst on the ovary. Due to microcracks on the surface of the cyst menstrual blood flows out of its cavity and can enter the retrouterine cavity. The following symptoms help identify this disease: pain in the abdomen, disruption of the menstrual cycle, heavy bleeding during menstruation. Conservative treatment includes reception hormonal drugs, NSAIDs, painkillers, vitamins and immunomodulators. If it does not produce results, then the cyst is removed (sometimes together with the ovary) or a puncture is performed;
purulent salpingitis. When the pyosalpinx ruptures, pus enters the abdominal cavity and into the “pocket” located on the back of the uterus. The patient develops additional symptoms- temperature rises, stomach hurts. Leukocytes increase in the blood. Urgent required surgical intervention. Will be deleted excess liquid, and then the woman has to long-term treatment, reducing inflammation, and antimicrobial therapy;
malignant tumors V abdominal cavity or small pelvis. With a tumor localized on the ovary, ascites often develops and fluid collects in the cavity of Douglas. Complex treatment - surgery, chemotherapy;
if a woman has had an abortion, then when performing an ultrasound, the doctor can also detect fluid in the described area.

Can fluid be found behind the uterus in a pregnant woman?

Fluid in the retrouterine space during pregnancy is detected only if the fertilized egg has attached to the in the wrong place, that is, when ectopic pregnancy. This will inevitably lead to a rupture of the wall of the fallopian tube, which is why fluid will penetrate behind the uterus. But an “incorrect” conception is usually detected (by pain, poor health, spotting) long before excess fluid accumulates.

The best form of treatment is timely prevention. In order to identify incipient pathologies in a timely manner, doctors recommend that women be examined by a gynecologist every six months or a year and have an ultrasound of the pelvis. This simple study will help to promptly identify possible violations functioning of the body.

What does fluid in the pelvis mean?

Accumulation biological fluid(blood, exudate) in the body cavity is called effusion. This state in itself is not an independent illness. Often this is a symptom of a disease, and the effusion does not appear in any way. Only a few women who had fluid in the pelvis on ultrasound complained of severe pain or abdominal discomfort or unusual vaginal discharge.

You don’t always need to be scared when you hear from a specialist who conducts ultrasonography, about the presence of effusion. Sometimes a small amount of free fluid visualized in the pelvis does not indicate any abnormalities and is a variant of the norm. For example, with stable menstrual cycle After ovulation, an ultrasound specialist can examine a small amount of the contents of the burst follicle just behind the uterus. Over the course of several days, this phenomenon goes away on its own.

Still, most cases of fluid detected in the pelvis during an ultrasound directly indicate that a woman needs to pay close attention to the state of her health. If this is the result of the study, the patient is referred to additional diagnostics in order to select appropriate therapy for treatment, because pathology may signal various diseases and states:

ectopic pregnancy;
endometriosis;
rupture of an ovarian cyst;
purulent salpingitis;
intra-abdominal bleeding;
liver damage;
tumor processes.

In the retrouterine space

If during an ultrasound the doctor detects fluid behind the uterus, and it is not a consequence of ovulation (has not resolved within 2-3 days), he has every reason to suspect that the patient has serious illness and even a life-threatening condition. Such symptoms may occur due to an inflammatory process in:

ovaries;
fallopian tubes Oh;
uterine cavity;
bladder.

One of the most vital dangerous conditions, in which fluid is clearly visible in the retrouterine space and which requires immediate surgery, is an ectopic pregnancy. The effusion occurs due to a rupture of the fallopian tube, where the fertilized egg was implanted. As a consequence of this in abdominal space blood penetrates and collects there.

To the list of main diseases internal organs, in which fluid in the pelvis is also visualized on ultrasound, include:

endometritis;
endometriosis;
adnexitis;
ovarian cyst;
acute purulent salpingitis;
internal bleeding caused by injury;
ascites – accumulation of fluid due to liver pathologies, progression malignant diseases, and etc.

Fluid in the uterus in old age

If we analyze the ultrasound data of postmenopausal women, when interpreting them, specialists often make a diagnosis of serosometer. It indicates that the patient has fluid in the uterine cavity. This condition is a consequence of the fact that inside the organ they develop inflammatory processes of various origins: infection, endometriosis, polyps, complications after old diseases genitourinary system etc. Serozometra can be suspected if a woman feels pain in the lower abdomen or pain during sexual intercourse.

Often, if during diagnosis a specialist observes fluid in the uterus, it is also visualized in fallopian tubes. This pathology suggests that in this part reproductive system the normal circulation of blood and lymph is disrupted. At further development such changes lead to the formation of closed cavities in the pipes, which stretch and thin their walls. Next, adhesions appear, which, if this process is not stopped in time, will quickly spread to all organs of the genitourinary system.

In the ovary in women

A formation with liquid contents that can occur on these organs is called a cyst. The most common reasons such pathology female body is the improper functioning of the gonads, hormonal imbalance, insufficient health prevention – hypothermia, not timely treatment chronic inflammatory processes, etc.

The cyst, which contains fluid in the ovary, does not show any symptoms in the first stages of development. Only over time, a woman may notice discomfort during sexual intercourse, changes in the nature of menstruation, problems with urination, and even an increase in the size of the abdomen, which indicates the growth of the formation. Such long-term manifestation of symptoms once again indicates the importance of regular gynecological examination, because when a cyst ruptures, there is a high probability of complications.

Causes of fluid accumulation

There are several factors that cause effusion. In fact, they are a number of diseases and injuries suffered by the patient. Thus, with endometriosis, areas of the endometrium that fall outside the organ bleed and fill the cavity behind the uterus with blood. In acute purulent salpingitis, pus and exudate collect in the rectouterine cavity. It is also important to know that in the vessels of the pelvic area, when venous circulation is disrupted, blood accumulates without spilling into the abdominal cavity.

Fluid behind the uterus cannot be called a disease. Rather, it is a harbinger of another gynecological disorder or a prerequisite for the emerging female disease. If the accumulation of water behind the uterus is the result of a disease, then such bright pronounced signs, How painful sensations when urinating, grayish discharge both during and after sexual intercourse. Liquid in posterior fornix needs to be treated.

Fluid in the uterus is most often observed in premenopausal women who have had an unsuccessful pregnancy (miscarriage), surgery (abortion or curettage), and may be a consequence of childbirth. Most often, there are no signs of the disease: no pain, no discomfort, no discharge. Fluid in the uterus is usually detected in girls and women planning to become pregnant after undergoing an ultrasound.

Factors contributing to the appearance of fluid in the uterine wall

There are a number of factors known that contribute to the formation of fluid in the uterus:

Unprotected sexual intercourse
Disturbed diet
Disturbed sleep patterns
Hormonal disbalance
Bad habits
Alcohol or nicotine addiction
Absence physical activity, passive activity
Nervous breakdowns, stress.

The diagnosis of serosometer (fluid accumulation in the uterus) is made when deformation of the abdominal part and an increase in the size of the uterus occur. In addition to deformation, there are a number of other symptoms that are possible due to fluid accumulation:

Pain in the lower abdomen
Copious watery discharge
Problems with urination (frequency and pain)
Slight increase in body temperature.

Due to the peculiarities of anatomy, fluid accumulation is observed in absolutely healthy representatives of the fair sex.

Treatment methods

Accumulated fluid behind the back wall of the uterus can form when heavy bleeding in the peritoneum. Fluid behind the uterus can sometimes be pus that has leaked into the abdominal cavity due to purulent salpingitis.

Free liquid in in rare cases can be considered normal, although, naturally, gynecologists note the absence of fluid behind the uterine wall as normal.

During the second stage of the cycle, water may be produced during ovulation, and in the first phase it may be due to the release of blood into the abdominal cavity during the menstrual cycle.

Experts advise regularly undergoing examinations and preventing the occurrence of infections and chronic inflammation. If any disease is nevertheless discovered, the next check by a gynecologist should be done no earlier than two months after treatment. To undergo the examination, you must take an immune test and a smear to check for the presence of chlamydia in the body.

Fluid accumulation in the uterus may be the result of acute endometritis. Another reason is a rupture of one of the ovaries or a cyst. There are also a number of other diseases of the organs that do not relate to the genital female system. Therefore it is recommended comprehensive examination the whole body.

Fluid may result from accumulation liquid blood, in medicine called a hemometer. Postpartum result of fluid accumulation in back wall the uterus may be a disturbed waste stream of lochia - lochometer.

Experts are not against it when a woman undergoes herbal treatment for the purpose of prevention. Recommended herbal decoctions include red brush and hogweed, calendula, sweet clover, coltsfoot, chamomile and sage, woodland mallow and centaury, rosemary, oak bark with cinquefoil and knotweed. Douching can also be used as a preventive measure. Use herbal decoctions Of course, it will not cause harm to the body, but before taking the course you should definitely consult with your doctor.

Preventive measures

Known following methods prevention of fluid accumulation in the walls of the uterus:

Physiotherapy
Vitamin therapy
Use of immunocorrectors
Treatment with fruit and vegetable juices.

Doctors recommend using mustard baths for 20 minutes. You should take a bath lukewarm, to do this you need to dissolve mustard powder and let the water cool. The use of such baths is contraindicated during premenstrual and menstrual periods, as well as after operations. Recommended use of honey vaginal suppositories and tampons. The cyclical use of these products should be checked with your gynecologist.

If surgical intervention was required to remove free fluid, and after that the ultrasound results showed the presence of fluid in the posterior fornix of the uterus, then do not be alarmed. The fluid can persist after surgery for several weeks, after which it will be favorably absorbed in the body. If other symptoms are observed, you should immediately consult a doctor.

This video is dedicated to women's health:

In some cases, during an ultrasound examination, a specialist detects fluid in the retrouterine space. Normally it shouldn't exist. How dangerous and serious is this? Your gynecologist should provide a decision on this issue. There is no need to worry prematurely - in some cases, treatment is not even required. But it is necessary to consult with specialists.

Where does free fluid come from in the pelvic cavity?

It is a generally accepted opinion that normally there should be no free fluid in any form in the retrouterine space. But, nevertheless, during ovulation, when the dominant follicle ruptures, there is a possibility that the liquid contents will enter the peritoneum. In this case, accumulation of substance behind the uterus may occur. The amount of free fluid in this situation is extremely small. Good specialist easy to distinguish similar case. Which, by the way, is considered an indicator of accomplished ovulation. Soon the fluid will disappear (dissolve or be resorbed).

Fluid in the retrouterine space and gynecological diseases

With this disease, endometrial cells grow in any part of the pelvis. These cells are also involved in menstruation, which means they can cause free fluid to accumulate behind the uterus. But other diseases can affect a similar process. For example, diseased organs secrete an exudative substance. If there are diseases of the pelvic organs (including reproductive organs), it is possible that the presence of free fluid will be diagnosed. Often similar symptom manifests itself in the presence of acute endometritis, as well as in the period after an abortion. Other reasons why fluid appears in the retrouterine space are ovarian rupture (anoplexy) or its cysts, purulent salpingitis. Also, a similar symptom can result from microperforation (small tear) of the endometriosis cyst, due to which its contents leak out. Fluid in the abdominal cavity (ascites) can accumulate due to malignant tumors, diffuse peritonitis, liver diseases, renal or heart failure, pelvioperitonitis and other diseases.

Fluid in the retrouterine space and ectopic pregnancy

One of obvious signs ectopic pregnancy when ovum attached to the fallopian tube, is the presence of free fluid. IN in this case fluid is blood that leaks from a damaged organ. The fertilized egg may be found outside the uterus. The fallopian tube may become deformed or ruptured. With other bleeding in the abdominal cavity, the presence of free fluid can also be diagnosed.

How does a normal state differ from a pathology?

First of all, the presence accompanying symptoms, which occur in the presence of a corresponding pathology. But some diseases occur in a latent form. Therefore, if the ultrasound specialist believes that there may be an abnormality, you should consult your doctor and undergo necessary examinations. Remember that timely treatment is extremely important.

Free fluid in a woman's abdomen, behind the uterus, is often found on ultrasound. If there is little fluid, its presence is not considered a pathology. Often fluid accumulates after menstruation or during ovulation. But in some cases, fluid behind the uterus on ultrasound data should be a cause for concern.

Causes of fluid accumulation behind the uterus

Fluid may end up in the cavity behind the uterus and be visualized on ultrasound for a variety of reasons. Some of them wear natural character and do not pose a health hazard. But normally there should be no fluid behind the uterus or in its cervix, so if it appears on an ultrasound, you should definitely consult a specialist.

What does fluid behind the uterus mean on an ultrasound?

The presence of fluid behind the uterus in sufficient quantity to be displayed on an ultrasound may indicate internal bleeding or inflammatory processes. In the first case, blood will accumulate in the abdominal cavity, in the second - exudative fluid. A small amount of fluid behind the uterus is considered normal; if an ultrasound showed a significant volume, this may indicate serious illnesses uterus or other pelvic organs.

Causes of fluid accumulation

Sometimes fluid behind the uterus appears due to an ectopic pregnancy; in this case, an ultrasound does not detect a fertilized egg in the uterine cavity. However, the patient's pregnancy test will show a positive result.

Also, fluid in the cavity behind the uterus is diagnosed on ultrasound due to endometriosis. The disease is characterized by the growth of endometrial tissue outside the uterus. Endometrial cells bleed during menstruation, which causes blood to appear in the abdominal cavity.

In addition, fluid behind the uterus is detected on ultrasound with purulent salpingitis, endometritis, rupture of the ovary or its cyst. A large volume of fluid indicates more serious diseases, such as malignant ovarian tumors and a number of other pathologies (heart or renal failure, cirrhosis of the liver), as well as about abundant internal bleeding for injuries in the abdominal area.

Fluid behind the uterus during ovulation

When breaking dominant follicle its contents enter the retroperitoneal space. In this case, the specialist may detect some fluid around the uterus on the ultrasound image. Soon after ovulation it will resolve without treatment or health consequences..

Fluid behind the uterus with inflammation

Sometimes inflammatory processes cause the appearance of exudative fluid in the abdominal cavity and behind the uterus; ultrasound can reliably diagnose it. As a rule, this occurs due to rupture of the pyosalpinx, an accumulation of pus in the lumen of the fallopian tubes. If an ultrasound showed fluid in the uterus, inflammation of the genitourinary organs is possible.

The inflammatory process is accompanied by fever and pain in the lower abdomen. If the diagnosis is confirmed, the specialist may prescribe medication (antibiotics) or recommend surgery.

How is the ultrasound procedure performed?

The procedure takes place or. The patient takes horizontal position on the couch, the specialist applies the gel to the abdomen and begins to move the sensor over it, then a transvaginal examination is possible. The procedure lasts no more than 15 minutes.

Decoding the result

Determining the exact volume of fluid behind the uterus using ultrasound data can be difficult due to the two-dimensional nature of the image. In addition, the fluid spreads between the organs, which also makes it difficult to determine its exact volume. IN modern medicine It is customary to distinguish the height of the formation by correlating the volume of liquid with it. With a height of up to 10 mm, the volume of liquid is considered insignificant, from 10 to 50 mm - moderate. At a height of more than 50 mm, the volume of fluid behind the uterus, diagnosed by ultrasound, is considered significant.