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# Discussion  - edad presentacion y sintomas  They are generally diagnosed 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