MAPS

Conservative treatment for urinary incontinence in Men After Prostate Surgery (MAPS)

The study involved two contemporaneous, but separate multicentre randomised controlled trials (following radical prostatectomy or endoscopic resection), each with two parallel groups. Men were recruited from about 34 UK hospitals. The men in the intervention groups received a physiotherapist or continence nurse assessment of their symptoms at about six weeks after surgery. Men in the control groups only received supportive lifestyle advice by post after randomisation. NHS and personal costs were estimated for every participant. Outcomes were subjective continence at 12 months and QALYs based on responses to the EQ-5D administered at baseline 3, 6, 9 and 12 months. Additional information to policy makers was derived from a simple economic model that considered what difference in continence rates would result in change in the conclusions about which treatment would be cost-effective.

Outcome and Translation

A recent Cochrane review has identified that although conservative treatment based on pelvic floor muscle training may be offered to men with urinary incontinence after either type of prostate surgery; there is insufficient evidence to evaluate its effectiveness, cost-effectiveness and effect on quality of life. This study helped inform whether conservative treatment reduces incontinence at one year after operation. A protocol of the study has been published to inform people of the ongoing work. This statement of the work we have committed to undertake will serve as a protection against publication bias.

HERU researchers involved in this research project: Luke Vale (HERU/HSRU) and Mary Kilonzo

External Collaborators: C Glazener, A Grant, C Ramsay, D Norrie, J N’Dow (HSRU, University of Aberdeen); G Dorey (University of West England); S Hagan (Nursing Research Initiative) and K Moore (University of Alberta)

maps

Click here for further details on this project

Publications

Glazener, C., Boachie, C., Buckley, B., Cochran, C., Dorey, G., Grant, A., Hagen, S., Kilonzo, M., McDonald, A., McPherson, G., Moore, K., N’Dow, J., Ramsay, C. and Vale, L. (2010) Conservative treatment for urinary incontinence in men after prostate surgery (MAPS). Final report submitted to NIHR Health Technology Assessment Programme, National Institute for Health Research.

Glazener, C., Boachie, C., Buckley, B., Cochran, C., Dorey, G., Grant, A., Hagen, S., Kilonzo, M., McDonald, A., McPherson, G., Moore, K., N'Dow, J., Norrie, J., Ramsay, C. and Vale, L. (2011) 'Conservative treatment for urinary incontinence in Men After Prostate Surgery (MAPS): two parallel randomised controlled trials', Health technology Assessment, 15(24), 1-290, iii-iv.

Glazener, C., Boachie, C., Buckley, B., Cochran, C., Dorey, G., Grant, A., Hagen, S., Kilonzo, M., McDonald, A., McPherson, G., Moore, K., Norrie, J., Ramsay, C., Vale, L. and N'Dow, J. (2011) 'Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials', Lancet, 378(9788), 328-337.

Presentations

Cochran, C., Glazener, C., McDonald, A., Norrie, J. and the MAPS trial Group University of Aberdeen. (Kilonzo, M. is a member of the group) (2008) 'Randomised control trial & error: the challenges of trial management in a geographically dispersed multi-centre trial', NHS Confederation Conference, June 2008.

Glazener, C., Boachie, C., Buckley, B., Cochran, C., Dorey, G., Grant, A., Hagen, S., Kilonzo, M., Moore, K., N’Dow, J., Ramsay, C. and Vale, L. (2010) 'A randomised controlled trial on conservative treatment (pelvic floor muscle training and bladder training) for urinary incontinence in men after prostate surgery (MAPS)', International Continence Society/International Urogynecological Association Annual Meeting, Toronto, August 2010.