Culdocentesis
Culdocentesis is a procedure that checks for abnormal fluid in the space just behind the vagina. This area is called the cul-de-sac.
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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.
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How to Prepare for the Test
You may be asked to walk or sit for a short time before the test is done.
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How the Test will Feel
You may have an uncomfortable, cramping feeling. You will feel a brief, sharp pain as the needle is inserted.
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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.
- You have suffered blunt abdominal trauma.
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Normal Results
No fluid in the cul-de-sac, or a very small amount of clear fluid, is normal.
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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 found in the fluid sample, you may need emergency surgery.
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Risks
Risks include puncturing the uterine or bowel wall.
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Considerations
You may need someone to take you home if you were given medicines to relax.
References
Braen GR, Kiel J. Gynecologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 57.
Eisinger SH. Culdocentesis. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 161.
Hur HC, Lobo RA. Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.
