Denonvilliers Fascia

fascia rectoprostatica/rectovaginalis

Denonvilliers fascia (rectoprostatic fascia) is a thin but tough membranous layer between the back of the prostate and seminal vesicles and the front of the rectum. It is thought to form from the fused walls of the deepest part of the rectovesical pouch in the fetus. In females the matching layer is the rectovaginal septum.

Anatomical Data

Boundaries & Contents

Location	Male pelvis, between the back of the prostate and seminal vesicles and the front of the rectum
Boundaries	Above: the floor of the rectovesical pouch of peritoneum Below: the perineal body In front: prostate and seminal vesicles Behind: rectum and its mesorectal fascia

Biomechanics

Function & Actions

Separates the prostate and seminal vesicles from the rectum, acting as a barrier to the spread of disease and as the anterior plane in rectal and prostate surgery.

Clinical Relevance

Clinical Notes

Denonvilliers fascia is the critical surgical plane landmark in radical prostatectomy, total mesorectal excision for rectal cancer, and repair of rectovaginal fistula. In TME, the anterior dissection plane on the posterior surface of Denonvilliers fascia protects the cavernous nerves of Walsh (neurovascular bundle) that lie immediately posterolateral. In prostatectomy, the choice of whether to incise anterior or posterior to the fascia determines whether the neurovascular bundle is preserved for erectile function.

Pathology

Common Injuries & Conditions

Neurovascular Bundle Preservation at Denonvilliers Fascia in Prostatectomy

The cavernous nerves for erection run posterolateral to the prostate along Denonvilliers fascia; nerve-sparing prostatectomy incises the fascia on the prostatic side, leaving the neurovascular bundle on the rectal side, while non-nerve-sparing surgery removes the fascia with the specimen to clear positive margins.

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