Culdocentesis is a procedure that checks for abnormal fluid in the space just behind the
vagina. This area is called the cul-de-sac.
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.
How to Prepare for the Test
You may be asked to walk or sit for a short time before the test is done.
How the Test will Feel
You may have an uncomfortable, cramping feeling. You will feel a brief, sharp pain as the needle is inserted.
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. Normal Results
No fluid in the cul-de-sac, or a very small amount of clear fluid, is normal.
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 seen in the area, you may need emergency surgery.
Risks include puncturing the uterine or bowel wall.
You may need someone to take you home if you were given medicines to relax.
Braen GR, Pierce DL. Culdocentesis In: Roberts JR, Hedges JR, eds.
Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 57.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, WA; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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