Rectovesical Fascia

fascia rectovesicalis (Denonvilliers)

Rectovesical fascia (Denonvilliers fascia in males) is the fibrous condensation between the posterior bladder and seminal vesicles anteriorly and the rectum posteriorly, derived from the fused peritoneal reflection in this space.

Region: Abdomen

Biomechanics

Function & Actions

Provides a tissue plane between the prostate/seminal vesicles and the anterior rectal wall, acting as an anatomical barrier for anterior rectal cancer spread and as the surgical dissection plane in radical prostatectomy and total mesorectal excision.

Clinical Relevance

Clinical Notes

Total mesorectal excision (TME) for rectal cancer follows the posterior aspect of this fascia to achieve a circumferential resection margin. In anterior rectal tumours, the anterior plane of the TME follows this fascia anteriorly, requiring careful dissection to avoid seminal vesicle or vaginal wall entry.

Pathology

Common Injuries & Conditions

Anterior TME Plane Using Rectovesical Fascia

The anterior plane of total mesorectal excision follows the posterior aspect of Denonvilliers fascia, separating the rectum from the seminal vesicles and prostate.

Rectovesical Fistula from Prostate Cancer Invasion

Anterior rectal wall fistulation from locally advanced prostate cancer penetrating through the rectovesical fascia, requiring diversion and palliative management.