MASTER:  Male synthetic sling versus Artificial urinary Sphincter Trial for men with urodynamic stress incontinence after prostate surgery: Evaluation by Randomised trial

Around one in five men who undergo prostate surgery for cancer or benign disease need to use incontinence pads because of leakage of urine when they walk around, cough or do any physical exertion. This impacts upon quality of life, can lower self-esteem and productivity, and can damage personal relationships. At present the only effective surgical treatment is insertion of a plastic artificial urinary sphincter (AUS) device which involves a major operation to place an inflatable cuff around the urine pipe close to the bladder, and inflating it to prevent leakage. A new male sling has been developed which, when inserted under the urine pipe, supports the outlet of the bladder but doesn’t need a pump. It is less expensive for the NHS (around £6,000) and easier to insert, but some men may still need a subsequent operation to insert an AUS if they feel their incontinence has not improved enough. It is also uncertain whether there are other advantages or disadvantages compared to the AUS, and whether men will be as satisfied with the results.

The ISRCTN for the trial is ISRCTN49212975 and more details are available at the project website.

HERU researchers involved in this research project: Mary Kilonzo

External collaborators: P Abrams (North Bristol NHS Trust); M Drake (University of Bristol); C Glazener, J Norrie, C Ramsay, C Boachie, K McCormack, G McPherson, A McDonald (HSRU, University of Aberdeen); R Pickard (University of Newcastle upon Tyne) and N Cotterill (University of Bristol)


Constable, L., Cotterill, N., Cooper, D., Glazener, C., Drake, M.J., Forrest, M., Harding, C., Kilonzo, M., MacLennan, G., McCormack, K., McDonald, A., Mundy, A., Norrie, J., Pickard, R., Ramsay, C., Smith, R., Wileman, S. and Abrams, P. (2018) 'Male synthetic sling versus artificial urinary sphincter trial for men with urodynamic stress incontinence after prostate surgery (MASTER): study protocol for a randomised controlled trial', Trials, 19(1), 131.

Abrams, P., Constable, L. D., Cooper, D., MacLennan, G., Drake, M. J., Harding, C., Mundy, A., McCormack, K., McDonald, A., Norrie, J., Ramsay, C., Smith, R., Cotterill, N., Kilonzo, M. and Glazener, C. (2021) 'Outcomes of a noninferiority randomised controlled trial of surgery for men with urodynamic stress incontinence after prostate surgery (MASTER)', European Urology, [Epub ahead of print].