Evidence map›Paper›PMID 33551297›Full record

Trial reportEuropean urology2021

Outcomes of a Noninferiority Randomised Controlled Trial of Surgery for Men with Urodynamic Stress Incontinence After Prostate Surgery (MASTER).

Paul Abrams, Lynda D Constable, David Cooper, Graeme MacLennan, Marcus J Drake, Chris Harding, Anthony Mundy, Kirsty McCormack, Alison McDonald, John Norrie and 6 more

Open access · hybridAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 3 pooled it
12.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. Article
  8. Artificial urinary sphincter surgery in the UK: are we following the guidelines?Annals of the Royal College of Surgeons of England · 2026
    Article
  9. Review
  10. Review
  11. Article
  12. Observational
  13. [Male slings-an overview].Urologie (Heidelberg, Germany) · 2026
    Review
  14. Article
  15. Comment on "The male sling implantation for urinary incontinence after prostate surgery: a real‑world multi‑center study in China".Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  16. Article
  17. Observational
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 1 country.

Paul AbramsBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Lynda D ConstableHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK. Electronic address: l.constable@abdn.ac.uk.
David CooperHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
Graeme MacLennanHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
Marcus J DrakeBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK; School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.
Chris HardingDepartment of Urology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.
Anthony MundyDepartment of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
Kirsty McCormackHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
Alison McDonaldHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
John NorrieUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Craig RamsayHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
Rebecca SmithBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Nikki CotterillBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK; Faculty of Health and Applied Science, University of West of England, Bristol, UK.
Mary KilonzoHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Cathryn GlazenerHealth Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK.
MASTER Trial Team
University of Aberdeen · GBNorth Bristol NHS Trust · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBUniversity College London Hospitals NHS Foundation Trust · GBUniversity of Edinburgh · GB

Funding

Chief Scientist Office HERU1Chief Scientist Office HSRU1Department of Health 11/106/01
6 · The paper itself

Abstract

backgroundStress urinary incontinence (SUI) is common after radical prostatectomy and likely to persist despite conservative treatment. The sling is an emerging operation for persistent SUI, but randomised controlled trial (RCT) comparison with the established artificial urinary sphincter (AUS) is lacking.

objectiveTo compare the outcomes of surgery in men with bothersome urodynamic SUI after prostate surgery. DESIGN, SETTING, AND

participantsA noninferiority RCT was conducted among men with bothersome urodynamic SUI from 27 UK centres. Blinding was not possible due the surgeries.

interventionParticipants were randomly assigned (1:1) to the male transobturator sling (n = 190) or the AUS (n = 190) group. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was patient-reported SUI 12 mo after randomisation, collected from postal questionnaire using a composite outcome from two items in validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire (ICIQ-UI SF). Noninferiority margin was 15%, thought to be of acceptable lower effectiveness, in return for reduced adverse events (AEs) and easier operation, for the sling. Secondary outcomes were operative and postoperative details, patient-reported measures, and AEs, up to 12 mo after surgery. RESULTS AND LIMITATIONS: A total of 380 participants were included. At 12 mo after randomisation, incontinence rates were 134/154 (87.0%) for male sling versus 133/158 (84.2%) for AUS (difference 3.6% [95% confidence interval {CI} -11.6 to 4.6], p

conclusionsUsing a strict definition, urinary incontinence rates remained high, with no evidence of difference between male sling and AUS. Symptoms and quality of life improved significantly in both groups, and men were generally satisfied with both procedures. Overall, secondary and post hoc analyses were in favour of AUS. PATIENT SUMMARY: Urinary incontinence after prostatectomy has considerable effect on men's quality of life. MASTER shows that if surgery is needed, both surgical options result in fewer symptoms and high satisfaction, despite most men not being completely dry. However, most other results indicate that men having an artificial urinary sphincter have better outcomes than those who have a sling.

Indexed as

Suburethral SlingsUrinary IncontinenceUrinary Incontinence, StressHumansMaleProstateTreatment OutcomeUrodynamicsArtificial urinary sphincterMale slingNoninferiorityRandomised controlled trialUrodynamic stress incontinence

Identifiers

PMID33551297
PMCPMC8175331
OpenAlexW3123474006

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.