Denonvilliers' fascia in women and its relationship with the fascia propria of the rectum examined by successive slices of celloidin-embedded pelvic viscera

Abstract

Purpose: The purpose of this study is to reexamine the detailed anatomy of Denonvilliers' fascia in women and to study its relationship with the fascia propria of the rectum.

Methods: Macroscopic dissection was performed and successive slices of celloidin-embedded pelvic viscera were examined. Of 25 formalin-fixed pelvic splanchnic organs removed from adult female pelves, 14 were cut midsagittally, dissected, and observed under anatomic microscopy, and 11 were embedded in celloidin and then made into successive slices.

Results: The rectovaginal septum was composed of anterior and posterior layers. The anterior layer was identified as Denonvilliers' fascia; the posterior layer as the fascia propria of the rectum. The bilateral insertions of Denonvilliers' fascia differ at different levels: at the cervix, Denonvilliers' fascia merged into the parametrium; at the upper vagina, it ended laterally at the paracolpium or fused with the fascia anterior to the vagina; at the middle vagina, the fasciae anchored to the arcus tendineus fasciae pelvis; at the lower vagina, it ended at the lateral side of the outlet of the levator ani muscles.

Conclusions: The rectovaginal septum is formed by Denonvilliers' fascia and the fascia propria of rectum and can potentially limit the spread of malignancy.