deletions | additions       diff --git a/discussion.md b/discussion.md  index 2bbb023..6b700eb 100644  --- a/discussion.md  +++ b/discussion.md 
...
# Discussion  Anterior sacral meningocele develops as a result of a rare defect characterized by focal erosion or hypogenesis of segments of the sacrum with herniation of the meningeal sac through the defect into the pelvis. It accounts for about 5% of  retrorectal masses and masses, it  is usually diagnosed in the second and or  third decades and are more prevalent in women. They may be asymptomatic or present as nonspecific symptoms such as long-term constipation, urinary dysfunction, lower back pain, or perineal hypoalgesia. These symptoms may be due to direct compression  of life. the herniated meningeal sac, spinal cord tethering, or sacral nerve root compression.\cite{6828997}  . ASM is either asymptomatic or  manifested by nonspecific symptoms as a result of pressure 
...
or high-pressure headache, nausea and vomiting related  to changes in body position [2]. Very  - edad presentacion y sintomas  They are generallydiagnosed in the second or third decades and are more prevalent in women. They may be asymptomatic or present as nonspecific symptoms such as long-term constipation, urinary dysfunction, dysmenorrhea, lower back pain, or perineal hypoalgesia. These symptoms may be due to direct compression of the herniated meningeal sac, spinal cord tethering, or sacral nerve root compression. In addition, congenital defects that may occur in autonomic innervation of the bladder and anal sphincter may be associated with constipation and urinary dysfunction\cite{6828997}  - confusion con quistes ovaricos  - approaches