How Is Culdocentesis Done?

Reviewed on 11/18/2020

Culdocentesis is a procedure to examine any abnormal fluid in the pouch-like space just behind the vagina
Culdocentesis is a procedure to examine any abnormal fluid in the pouch-like space just behind the vagina

Culdocentesis is a procedure to examine any abnormal fluid in the pouch-like space just behind the vagina (cul-de-sac or pouch of Douglas).

In the culdocentesis procedure:

  • The physician will first perform a pelvic examination
  • Lying in the same position with your head elevated to 60 degrees, the physician inserts a lubricated tool, known as a speculum, to examine the cervix (the neck of the womb)
  • Next, the physician cleanses the vagina and cervix with antiseptic and applies 2% Lidocaine gel to the vaginal lip or cervical lip
  • Using a tool called a tenaculum, the physician grasps the cervix and lifts to expose the vaginal fold (posterior fornix)
  • Next, the physician injects normal saline into the cul-de-sac and empties it. After injecting the normal saline, the physician pulls back the syringe plunger while slowly withdrawing the needle
  • The fluid collected is sent for analysis
  • If there’s no fluid collected in the first attempt, the physician withdraws the needle and then reintroduces it

How are the results of culdocentesis interpreted?

Depending on the type of fluid withdrawn, the result interpretation involves:

How to prepare for a culdocentesis?

To prepare for culdocentesis, you have to follow these instructions:

  • Detail your medical and medication history to your physician
  • Undergo a pelvic examination for the physician to identify the abnormality of the cul-de-sac
  • Understand each step of culdocentesis to know what to expect from the procedure
  • Give your informed consent after understanding the procedure thoroughly
  • You may need to walk or sit upright for 10 to 15 minutes to allow the fluid to pool into the cul-de-sac
  • Inform about any drug allergies or substance allergy to your physician
  • Quit cigarette smoking and other nicotine products before the procedure
  • Avoid alcohol for a few days before the surgery
  • You may have to undergo specific tests before the procedure, which include:

What to expect after the culdocentesis procedure?

After a culdocentesis procedure:

What are the complications of the culdocentesis procedure?

The complications of culdocentesis procedure include:

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References
https://emedicine.medscape.com/article/83097-overview#a8

https://www.uptodate.com/contents/culdocentesis#H5

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