Endometriosis is a gynecological disorder identified by the presence of ectopic endometrial tissue outside the uterus. Largely, it affects reproductive-aged women and is a major cause of infertility. Clinical manifestations of endometriosis include dyspareunia, cyclic menstrual pain, chronic pelvic pain, and dyschezia, all of which can affect the patient’s quality of life and health severely; therefore, it is paramount that medical treatment is initiated as soon as endometriosis is suspected clinically. In this review, we examine the known anatomic principles of endometriosis in the literature and outline ways to manage patients with this condition better.

Dyspareunia can be described as continuous unremitting or intermittent pain associated with intercourse. It can be classified based on the location of the pain - entry or deep dyspareunia, or based on when the pain was first experienced - primary or secondary dyspareunia. There are different causes of dyspareunia and some of the most important causes include the following: vulvodynia, postpartum dyspareunia, endometriosis, inadequate vaginal lubrication or arousal, and other anogenital causes such as hemorrhoids and anal fissures. In this review, our objective is to apply the anatomical knowledge of dyspareunia to patient care, increase awareness among clinicians about the diverse etiology of dyspareunia and ensure that the whole patient, not just the pain of dyspareunia is being treated as the causes of dyspareunia can be due to various pathologies. Clin. Anat., 31:1013-1017, 2018. © 2018 Wiley Periodicals, Inc.

No abstract

It has been proposed that hydrocephalus in children with myelomeningocele (MMC) can indicate a low intelligence quotient (IQ). Others have argued that it is not the mere presence of hydrocephalus but the superimposition of cerebrospinal fluid (CSF) infections, multiple shunt procedures, and other CNS complications that lead to the lowering of IQ in these patients.In this paper, we review the literature to clarify the information about IQ in patients with MMC and whether it changes after infections and shunt procedures. We have also considered the other factors that could be involved in the IQ development of these patients and the differences revealed by the brain imaging of individuals with MMC.The consensus remains that patients with MMC, with or without complications, tend to have a lower IQ than those without MMC. Hydrocephalus appears to decrease the IQ further in MMC patients. Some have proposed that prenatal repair of the MMC lesion reduces the need for ventricular shunting after birth, thus decreasing the risk of shunt complications such as a CNS infection, which can have a negative effect on IQ. More studies are needed to assess other risk factors (apart from folate deficiency) and genetic factors that could contribute to the development of MMC and their possible effects on patient IQ.

Physicians should be aware of atypical MS and related conditions in order to further assess these patients for risk of any underlying genetic disorders.