Cyst in Denonvilliers Space | Rectovaginal Space скачать в хорошем качестве

Cyst in Denonvilliers Space | Rectovaginal Space

Why Cyst in Denonvilliers’ Space is Challenging Surgery Deep pelvic location → narrow space, limited access. Vital relations → rectum, bladder, ureters, seminal vesicles/uterus, neurovascular bundles. High risk of injury → rectal perforation, urinary tract injury, autonomic nerve damage. Dense adhesions → cyst often stuck to fascia and viscera. Difficult pre-op diagnosis → origin not always clear on imaging. Requires precision → safe excision only with advanced laparoscopic/robotic expertise. Cysts in the Denonvilliers’ space are surgically demanding because the space lies between the rectum and prostate/seminal vesicles in males, and between the rectum and vagina/uterus in females. This region is compact, with vital organs and neurovascular structures in close contact. Exposure is difficult due to the deep pelvic location and narrow operating field. Anatomical proximity to rectum, bladder, and pelvic autonomic nerves increases the chance of inadvertent injury, which can cause severe complications such as rectal leak, urinary fistula, or sexual dysfunction. Adhesions are common around these cysts, making dissection tedious. Pre-operative uncertainty about the cyst’s origin may complicate surgical planning. Excision requires meticulous dissection, preferably with magnified visualization by laparoscopy or robotics, to remove the cyst completely while preserving organ function. Hence, cysts in Denonvilliers’ space are considered high-risk and technically challenging, demanding expertise, anatomical mastery, and advanced surgical skill.