Many men experience some urinary incontinence after prostate surgery, but it usually improves with time. The chance of urinary incontinence is higher after radical surgery for cancer. The MAPS study (Men After Prostate Surgery) aims to find out if physical treatment based on training the pelvic floor muscles can help men regain continence. Current evidence suggests that it can, but it is not conclusive, and the training is time-consuming and resource-intensive. Over a two-year period, around 17,000 men having prostate surgery in 26 UK hospitals will be approached three weeks after their surgery. Those who are experiencing urinary incontinence will be invited to join the study. 800 men (400 after radical and 400 after endoscopic surgery) who wish to take part will then be randomly allocated to treatment with a physiotherapist or continence nurse, or to a control group. The treatment aims to teach men to contract their pelvic floor muscles. Sometimes a monitor will be used so men recognise good muscle contractions (called biofeedback). Selected men will be taught how to lengthen the time between voids (bladder training). Men in the control group will receive usual care through their GP. We will find out not only if men's continence has improved but also if their quality of life has changed with active treatment. In addition, we will assess whether any benefits justify the additional costs to the men and to the NHS.

The collaborators have the appropriate mix of expertise in management of prostate diseases, research on incontinence and in performance large multicentre cost-effectiveness trials.

Aberdeen is the lead coordinating centre of this national multicentre study.