Pouch of Douglas Fluid: Causes, Evaluation

Pouch of Douglas Fluid: Causes, Evaluation
Published on, 20 January, 2024. Answered by Dr. Anh Nguyen and Verified by Dr.Galen Team
Patient Question

Hello Doctor,


I've been informed that there's 13ml of free fluid in my pouch of Douglas. Could you please help me understand what might be causing this, and what potential treatments are available? Is this amount of fluid considered normal?


Answered by Dr. Anh Nguyen


Thank you for reaching out to Dr. Galen. Please find the below response to your query.


Normal Fluid Presence:

1. Pouch of Douglas, situated beside the uterus, often contains small amounts of fluid.

2. Normal physiological levels range from 1 mL to 5 mL, with a slight increase post-ovulation.


Potential Causes of Excess Fluid:

1. Infection, pregnancy complications, endometriosis, fibroids, cysts, follicle or uterine rupture.

2. Fertility treatments can also contribute to elevated fluid levels.


Pathological Indicators:

1. Uncommonly high fluid levels may be linked to pathological conditions such as ruptured cysts, ectopic pregnancies, or ascites.

2. Infections in the pelvis or appendix can also lead to fluid accumulation.


Signs of Concern:

1. Larger than normal fluid amounts in the pouch of Douglas may raise concerns.

2. Rule out malignancies by assessing symptoms like abdominal pain, distension, lumps, altered stool caliber, or abnormal uterine bleeding.


Diagnostic Steps:

1. An abdominal scan has been performed, but further examination by a trusted doctor is crucial.

2. Share the scan results for expert analysis to determine a conclusive diagnosis.


Next Steps:

1. Expert diagnosis will guide appropriate treatment options.

2. Malignancies will be ruled out or addressed based on the findings.

3. Collaborate closely with your healthcare professional for personalized guidance and care.




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About Dr. Anh Nguyen

Dr. Anh Nguyen

Obstetrician and Gynecologist

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