A Difficult Caesarean Section in the Woman with the Erroneous Development of Uterovesical Pouch

Kwang, K Y; Seo, J H; Kim, M J; Park, Y K; Koh, M H; Lee, T H

Abstract

The urinary and reproductive systems are closely related both anatomically and embryologically that must be inevitably considered together. In all vertebrates there is a complex system of body cavities which are mesodermal in origin and from such spaces as the pleural, the pericardial, and the peritoneal cavities. They are lined by a layer of flattened cells or mesothelium and are often spoken of as serous cavites. These cavities give us an easy access to the target organ when we do surgeries. Their surfaces are covered with a film of moisture which allows free movement of the visceral surfaces upon each other. Fusion of the paramesonephric ducts brings together two peritoneal mesenchymal folds, which form the right and left broad ligaments and 2 peritoneal compartments of pelvic cavity, the uterorectal pouch of Douglas and uterovesical pouch. Well formed uterovesical peritoneal pouch enables us to incise the lower segment of uterus easily. We confronted the difficulty of approaching to the uterus for low segment transverse incision in pregnant woman with uterovesical pouch defect who had never undergone pelvic surgery and no history of any pelvic inflammatory diseases. So it could be hypothesized that the defect of uterovesical peritoneal pouch can be occur by erroneous development prenatally.