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This trial found that synthetic sling was non-inferior to artificial urinary sphincter for self-reported continence rates after 12 months, and also cost less.

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Lynda Constable 1,*, Paul Abrams 2, David Cooper 1, Mary Kilonzo 3, Nikki Cotterill 4, Chris Harding 5, Marcus J Drake 6, Megan N Pardoe 2, Alison McDonald 1, Rebecca Smith 7, John Norrie 8, Kirsty McCormack 1, Craig Ramsay 1, Alan Uren 2, Tony Mundy 9, Cathryn Glazener 1, Graeme MacLennan 1

1 Health Services Research Unit, University of Aberdeen, Aberdeen, UK
2 Bristol Urological Institute, Southmead Hospital, Bristol, UK
3 Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
4 Faculty of Health and Applied Sciences (HAS), University of the West of England, Bristol, UK
5 Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
6 Bristol Urological Institute, University of Bristol, Bristol, UK
7 Research and Innovation, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
8 Usher Institute, Centre of Population Health Sciences, University of Edinburgh, Edinburgh, UK
9 Urology, University College Hospital, London, UK
* Corresponding author Email: l.constable@abdn.ac.uk

Declared competing interests of authors: Paul Abrams reports consultancies with Astellas Pharma Inc. (Tokyo, Japan), Ipsen (Paris, France) and Recordati (Milan, Italy); reports being a lecturer for Astellas Pharma Inc., Pfizer Inc. (New York, NY, USA), Cipla (Mumbai, India), Ferring Pharmaceuticals (Saintt-Prex, Switzerland) and Sun Pharma (Mumbai, India); and is a triallist for Astellas Pharma Inc., outside the submitted work. Chris Harding reports personal fees from Astellas Pharma Inc., Medtronic (Dublin, Ireland) and Allergan (Dublin, Ireland); grants from Medtronic; personal fees from Teleflex Medical (Wayne, PA, USA) and GlaxoSmithKline (Brentford, UK); and research grants from the National Institute for Health and Care Research (NIHR) and The Urology Foundation (London, UK) outside the submitted work. Marcus J Drake reports personal fees from Astellas Pharma Inc. and Pfizer Inc., outside the submitted work and is a trustee of the International Continence Society (Bristol, UK). Nikki Cotterill reports grants from NIHR during the conduct of the study. Craig Ramsay reports membership of the NIHR Health Technology Assessment (HTA) General Board (2017–present). John Norrie reports grants from the University of Aberdeen (Aberdeen, UK) and the University of Edinburgh (Edinburgh, UK) during the conduct of the study and declares membership of the following NIHR/Medical Research Council boards: Efficacy and Mechanism Evaluation (EME) Funding Board (chairperson, 2019–present), Cardiopulmonary Resuscitation Decision-making Committee (2016), HTA Commissioning Board (2010–16), HTA Commissioning Sub-Board (Expression of Interest) 2012–16, HTA Funding Boards Policy Group (2016), HTA General Board (2016–19), HTA Post-Board Funding Teleconference (2016–19), NIHR Clinical Trials Unit Standing Advisory Committee (2017–present), NIHR HTA and EME Editorial Board (2014–19) and Pre-exposure Prophylaxis Impact Review Panel (2017–present).

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