Ovarian torsion is among the gynecological life-threatening conditions that may require urgent surgical intervention among the appearance of clinical manifestations. The most common clinical manifestations include severe abdominal pain, nausea extending to vomiting. The ovarian torsion is not limited to children only. However, it can also occur in adult females, either pregnant or non-pregnant. The etiology of the disease tends to be related to the weakness of the uterine ligaments or malpositioning of it due to known and unknown causes. Despite that, the surgical intervention is needed to release the torsion. Sometimes, it can lead to adverse events or side effects such as decreased blood flow to the surrounding structures. Which by role may lead to unpleasant complications and clinical manifestations of hemorrhage and shock. In this article, we reviewed the topic of ovarian torsion from different aspects, including the definition, causes, clinical evaluation, and clinical management and its common complications.

A cystocele is usually found to protrude the urinary bladder through the vaginal wall. Various causes have been reported in the literature for the pathogenesis and development of cystocele. These can cumulatively lead to a remarkable weakness in the muscular and connective tissue layers related to the urinary bladder and anterior vaginal wall. The present study discusses the etiology, staging, and management of patients with cystocele. Evidence indicates that a defect within the pelvic-floor supporting system can significantly lead to the development of cystocele. Parity, increasing age, and obesity are the main associated risk factors for developing these events. Staging is important to decide the most suitable treatment plan, which might be conservative or surgical. Some patients do not require any management approach, being asymptomatic, and refuse the current treatment modalities. Surgery has been associated with enhanced outcomes and can be conducted via two different approaches, including anterior colporrhaphy and sacral colpopexy.

Although intrahepatic cholestasis of pregnancy is not a serious one, it can be very distrustful to the affected women. It can also lead to significant complications and adverse events over the fetus as what has been previously reported that it is linked with stillbirth, fetal distress, and premature labor, especially in severely affected cases. Many treatment modalities have been proposed to relieve pruritis and enhance the levels of bile acids within the serum of the affected women. The administration of ursodeoxycholic acid has been studied by various studies in the literature, and evidence is conflicting about its potential efficacy and safety. However, recent evidence for a meta-analysis indicates that the modality can reduce pruritis. Nevertheless, the effect is minimal and not significant when compared to the placebo group. No significant differences were also noticed between the placebo and treatment groups. We also found that other treatment modalities than ursodeoxycholic acid can also be administered. Nonetheless, these were not adequately discussed in the literature, and therefore, should be cautiously administered within the clinical settings. Finally, further trials are needed to validate of the current evidence and enhance the quality of reporting and planning proper management guidelines.