AimSacral neuromodulation (SNM) is approved for the treatment of faecal incontinence (FI) in a two‐stage technique. With standardized implantation, approximately 90% of patients undergo successful Stage I operation and proceed to a permanent implant (Stage II). The aim of this work was to explore the feasibility of SNM as a one‐stage procedure and report the 24‐week efficacy.MethodThis study included patients diagnosed with idiopathic FI or FI due to an external anal sphincter defect ≤160° and one or more episodes of FI per week despite maximal conservative therapy. Patients were offered a one‐stage procedure if a motor response of the external anal sphincter was achieved in three or more poles with at least one at ≤1.5 mA at lead placement. Patients were followed for 24 weeks. Their evaluation included the Wexner/St Mark's Incontinence Score, Faecal Incontinence Quality of Life score (FIQoL), a visual analogue scale (VAS) for assessing patient satisfaction and a bowel habit diary.ResultsSeventy‐three patients with a median age of 60 years (interquartile range 50–69 years) completed this prospective study. Episodes of FI were significantly reduced at the 24‐week follow‐up, from 13 (8–23) at baseline to 2 (0–5) (p‐value = 0002). A ≥50% reduction in the number of FI episodes was achieved in 92% of participants. The Wexner score improved significantly from 16 (14–17) at baseline to 9 (5–13) (p‐value < 0.001), and the St Mark's score improved significantly from 18 (16–20) to 11 (7–16) (p‐value < 0.001). All domains in the FIQoL score and VAS for patient satisfaction improved significantly following the one‐stage procedure.ConclusionA one‐stage implantation procedure is feasible in selected patients with FI, significantly improving continence, quality of life and patient satisfaction after 24 weeks of follow‐up.

中文翻译：

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一阶段植入骶神经调节治疗大便失禁——一项前瞻性研究的短期结果

AimSacral 神经调节 (SNM) 被批准用于以两阶段技术治疗大便失禁 (FI)。通过标准化种植，大约 90% 的患者成功进行第一阶段手术并进行永久种植（第二阶段）。这项工作的目的是探索 SNM 作为一阶段手术的可行性并报告 24 周疗效。方法本研究包括诊断为特发性 FI 或因肛门外括约肌缺损 ≤160° 和一项或多项尽管采取了最大程度的保守治疗，每周仍有 FI 发作。如果在三个或更多电极上实现了肛门外括约肌的运动反应，并且在引线放置时至少有一个电流≤1.5 mA，则为患者提供一阶段手术。对患者进行了 24 周的随访。他们的评估包括 Wexner/St Mark 失禁评分、大便失禁生活质量评分 (FIQoL)、用于评估患者满意度的视觉模拟量表 (VAS) 和排便习惯日记。 结果 73 名患者的中位年龄为 60 岁（四分位数间距 50-69 岁）完成了这项前瞻性研究。24 周随访时，FI 发作次数显着减少，从基线时的 13 次（8-23 次）减少到 2 次（0-5 次）（p‐值 = 0002)。92% 的参与者的 FI 发作次数减少了 ≥50%。Wexner 评分从基线时的 16 (14–17) 显着提高至 9 (5–13)（p‐值 < 0.001)，圣马克分数从 18 (16-20) 显着提高到 11 (7-16)（p‐值 < 0.001)。一阶段手术后，FIQoL 评分和 VAS 的所有领域的患者满意度均显着改善。结论 对于选定的 FI 患者，一阶段植入手术是可行的，在 24 周随访后显着改善了自控能力、生活质量和患者满意度向上。