Objective
The presence or absence of Denonvilliers’ fascia in either sex has been debated for more than 100 years. The original description of the fascia was based exclusively on findings observed in 12 male cadavers, although Denonvilliers gave no account of its existence in women. Not surprisingly, its clinical significance in women remains controversial. Kleeman et al. report no similar fascia present between the rectum and vagina, whereas Kraima et al. support its presence. In women, it is considered important in the treatment of rectocele or when mobilizing the rectum in the correct avascular plane to avoid injury to the anterior rectal wall and associated adjacent neurovascular structures. The aim of this study was to investigate the in situ detailed architecture of Denonvilliers’ fascia in female cadavers by the us of a novel epoxy sheet plastination technique.
Study Design
Three sets of serial frozen sections (2 transverse, 1 sagittal) from 3 adult female cadavers (age range, 58−86 years) were studied. Two of the 3 sets were plastinated and examined by microscopy. None of the cadavers showed signs indicative of previous surgical intervention, injury, physical abnormalities, or unknown previous pathologies within the pelvis. Their history of vaginal birth was unknown. The cadavers were bequeathed for medical education and research purposes under the Human Tissues Act. Generally, the study of fascia in cadavers is complex because of the difficulty in meticulously dissecting fine fibrous structures. Histology may overcome the problem, although there are difficulties encountered with sample size, alteration of tissue architecture during decalcification, and in tracing the origin of a fibrous structure. Alternatively, epoxy sheet plastination technology, in which water and lipid of a specimen are replaced by curable transparent epoxy resin, not only preserves the in situ orientation and morphology of tissues but also allows examination at both the macroscopic and microscopic levels.
Study Design
Three sets of serial frozen sections (2 transverse, 1 sagittal) from 3 adult female cadavers (age range, 58−86 years) were studied. Two of the 3 sets were plastinated and examined by microscopy. None of the cadavers showed signs indicative of previous surgical intervention, injury, physical abnormalities, or unknown previous pathologies within the pelvis. Their history of vaginal birth was unknown. The cadavers were bequeathed for medical education and research purposes under the Human Tissues Act. Generally, the study of fascia in cadavers is complex because of the difficulty in meticulously dissecting fine fibrous structures. Histology may overcome the problem, although there are difficulties encountered with sample size, alteration of tissue architecture during decalcification, and in tracing the origin of a fibrous structure. Alternatively, epoxy sheet plastination technology, in which water and lipid of a specimen are replaced by curable transparent epoxy resin, not only preserves the in situ orientation and morphology of tissues but also allows examination at both the macroscopic and microscopic levels.
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