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Introduction. Myelomeningocele (MMC) is an embryologic neural tube defect. Aim. To determine defecatory habits in MMC patients older and younger than 4 years old according to medullary level and factors affecting catharsis. Patient and methods. Descriptive study of prospective cohort by multidisciplinary team at Posadas Hospital, from March 2003 to March 2017. Inclusion criteria: MMC catered. Exclusion criteria: colostomizated. Results. n = 301. Female: 54%. Age: 1 month to 17 years. Median age: 3 years. GI: 178 patients ≤ 4 years. GII: 123 patients > 4 years. In GI: 82% normal defecation vs. 15% in GII; GI 18% constipation; GII 11% constipation, 79% incontinence. According medullary level: high (thoracic and high lumbar), low (middle lumbar, low lumbar and sacral). Constipation in GI: High 24% and in Low 14% (p = 0.13). GII incontinence in 86% High and in 73% Low (p = 0.06). 37% of walkers without aid, 23% of the children using valves and only 12% of wheelchair bound patients were continent (p = 0.01). Normal school: 30% continent; and 6% who continent attended special school (p = 0.001). Conclusions. 1) More frequent evacuation abnormalities after age of sphincteric control. 2) In ≤ 4 years old, constipation wasn´t related to medullary level; ≥ 4 years old patients defecatory trouble was directly. proportional to medullary level. 3) Special school pupils and wheelchair bound patients > 4 years experienced incontinence degree significantly higher. 4) No difference in defecatory trouble with or without urinary Catheterization. 5) More incontinence in > 4 with ventriculoperitoneal shunt. 6) Functional encopresis must be considered in association with organic factors in this patients.

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