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The patients may remain asymptomatic or present as nonspecific symptoms such as long-term constipation, urinary dysfunction, lower back pain, or perineal hypoalgesia.\cite{21977087}\cite{6470791} These symptoms may be due to direct compression of the herniated meningeal sac, spinal cord tethering, or sacral nerve root compression, diminished rectal and detrusor  tone, or numbness and paresthesia in the lower sacral  dermatomes.\cite{11956924} Also fluid shifts between the sac and the spinal subarachnoid space can cause intermittent low or high-pressure headache, nausea and vomiting related to changes in body position.\cite{6828997} As a result of this nonspecific symptoms, the diagnosis can be difficult and occasionallyit  can be confused with other entities. - confusion con quistes ovaricos y Dx