One‐stage implant in sacral neuromodulation for faecal incontinence – short‐term outcome from a prospective study.

Aim: Sacral 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. Method: This 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. Results: Seventy‐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. Conclusion: A 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. [ABSTRACT FROM AUTHOR]