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Introduction: Verneuil disease, or perianal hidradenitis suppurativa (HS), is a chronic suppurative disease with a tendency to develop sinus formation, fibrosis, and sclerosis, having a great impact on quality of life. HS affect the apocrine sweat glands or sebaceous glands and may arise in each of the regions where the apocrine glands are prominent: the axilla, breast aureole, umbilicus, perineum, groin, and buttocks. We present here moderate and extensive HS cases, with their respective treatment methods and outcomes. Methods: A retrospective re-view of 6 patients’ medical records from January 2001 to December 2010. Results: The 6 patients underwent treatment for HS in the gluteal and perianal regions with surgical excision. Five of the patients were male (83%). The median age was 42.5 years. We performed a total of 8 operations on these patients. In 3 patients, the wound was left open for secondary healing, and the mean time for complete wound healing was 11.3 weeks (range: 9.5-19 weeks). Delayed skin grafting was used for 2 patients in whom the wounds had been left open after the first operation. In this group, complete wound healing took 2 months in total. One patient underwent primary wound closure using rotation flaps, with a complete healing time of 2 weeks. Successful treatment without recurrence was accomplished in 5 (83.3%) of the patients. Conclusion: The conservative treatment methods had little effect, particularly on gluteal and perianal/perineal HS. The only successful treatment was wide surgical excision. Management of the wound after wide excision should be tailored to the individual patient.

Purpose. Diagnostic hysteroscopy has become a well-established modality for evaluating the uterine cavity, but provides no information regarding tubal patency. The aim of the present study was to investigate the diagnostic value of transvaginal sonography (TVS), performed directly after diagnostic hysteroscopy, for assessing tubal patency in infertile women, and to compare the findings with those obtained by means of laparoscopic chromopertubation. Methods. A total of 56 infertile patients were referred to our endoscopic unit for laparoscopic chromopertubation in the period from September 2008 to January 2010. Diagnostic hysteroscopy, followed by TVS, was carried out prior to laparoscopic chromopertubation. The collection of free fluid in the pouch of Douglas was accepted as evidence of tubal patency. The findings of TVS and laparoscopic chromopertubation were compared. The data were analyzed for the sensitivity, specificity, accuracy, positive-predictivevalue, and negative-predictive value of the combination of hysteroscopy and TVS in detecting unilateral or bilateral tubal patency. Results. The presence of fluid in the pouch of Douglas was observed in 37 of the 56 cases. In 36 of these cases, unilateral or bilateral tubal patency was confirmed by laparoscopic chromopertubation. In 17 of the remaining 19 cases (without fluid in the pouch of Douglas during ultrasound), bilateral tubal occlusion was confirmed by laparoscopic chromopertubation. Diagnostic hysteroscopy followed by TVS showed a high sensitivity and specificity for the assessment of tubal patency. Conclusions. TVS performed directly after diagnostic hysteroscopy in infertile patients provides additional nformation regarding tubal patency. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound 40:68–73, 2012

We present an unusual case of a 28-year-old woman who had termination of pregnancy at 18 weeks of gestation. She visited our clinic with a history of secondary infertility for 3 years. A transvaginal ultrasonography revealed a hyperechogenic image that suggested presence of an intrauterine contraceptive device (IUCD). Hysteroscopy revealed a foreign body in the uterine cavity. The foreign body was removed with a hysteroscope using additional instruments that were not designed for hysteroscopy. Histological examination of the foreign body revealed fragments of dead bone.