Ok I have dissected a human, and been at enough hysterectomies, gynaecological laparoscopies and c-sections to feel able to comment, but bear with me, because I’ve been at work for the last 28hours straight.
First up mks57- intra-abdominal fluid doesn’t leak out via the vagina, having tracked down from the fallopian tubes, even when the intra-abdominal pressure is immense. Women with liver disease or ovarian cancer can often have litres of fluid sitting within the abdomen. It unfortunately doesn’t leak out vaginally and often has to be removed with a large needle through the abdominal wall.
Think of the fallopian tube as like a piece of really over-cooked macaroni- it sits closed and is quite difficult to get open. It’s not like a raw or half-cooked macaroni where you could imagine it working like a little straw.
SharkB8 The “ligaments” holding the pelvic organs in place are generally speaking not true ligaments like the ones in your knee, but are simply folded layers of the peritoneum and fascia- i.e. not very strong and not very supportive. That is why a lot of ladies suffer from prolapse, especially after childbirth.
Pullet The human peritoneum might be slightly thicker than you realise. The parietal peritoneum is visible as a whiteish sheet, although the visceral peritoneum is much thinner (it looks a bit like clingfilm/Saran wrap).
While the uterus and part of the bladder are covered by parietal peritoneum, and so are separated from the intestines, the fallopian tubes and ovaries aren’t and so are in the same cavity as the intestines. At laparoscopy dye that is injected through the cervix to test for tubal patency will pool in the pouch of Douglas (the bit at the bottom between the vagina and the rectum, the rectouterine pouch), and if a laparoscopy is done during menstruation you can often see menstrual blood sitting there too.
This image of a dissection specimen (with the bowel removed) might help people visualise things 3D (not for the squeamish).
This image might be helpful too. It is a cross-sectional diagram and is much less gruesome. The blue-ish areas are those contained within the abdominal peritoneum, as you can see the uterus is separate from the bowel, but the fallopian tubes and ovaries are within the peritoneum with the intestines.
The ovaries are each about the size of the first joint of your thumb, the fallopian tubes about the length of your thumb. The fimbriae (fringed outer ends) of the fallopian tubes touch the ovary or lie just above or beside it. The non-pregnant uterus is about the size of a small avocado.
When doing a c-section, we cut into the lower segment, this is the part of the uterus that is still covered by peritoneum, and if you look at a diagram you’ll see that the bladder has to be very carefully moved down and out of the way to avoid cutting it. We look for the white line that shows the end of the parietal peritoneum and sometimes it can be hard to see.
Hope this was helpful.
