In a systematic review and meta-analysis, Angulo and colleagues (2019) examined the safety and efficacy of ATOMS compared to ProACT for male SUI according to literature findings; studies on female or neurogenic incontinence were excluded. Differences between ATOMS and ProACT in primary objective: dryness status (no-pad or 1 safety pad/day) after initial device adjustment, and in secondary objectives: improvement, satisfaction, complications and device durability, were estimated using random-effect model. Statistical heterogeneity among studies included in the meta-analysis was assessed using tau2, Higgins´s I2 statistics and Cochran´s Q test. Combined data of 41 observational studies with 3,059 patients showed higher dryness (68 % versus 55 %; p = 0.01) and improvement (91 % versus 80 %; p = 0.007) rate for ATOMS than ProACT. Mean pad-count (-4 versus -2.5 pads/day; p = 0.005) and pad-test decrease (-425.7 versus -211.4 cc; p < 0.0001) were also significantly lower. Satisfaction was higher for ATOMS (87 % versus 56 %; p = 0.002) and explant rate was higher for ProACT (5 % versus 24 %; p < 0.0001). Complication rate for ProACT was also higher, but not statistically significant (17 % versus 26 %; p = 0.07). Mean follow-up was 25.7 months, lower for ATOMS than ProACT (20.8 months versus 30.6 months; p = 0.02). The rate of working devices favored ATOMS at 1-year (92 % versus 76 %; p < 0.0001), 2-years (85 versus 61 %; p = 0.0008) and 3-years (81 % versus 58 %; p = 0.0001). Significant heterogeneity was evidenced, due to variable incontinence severity baseline, difficulties for a common reporting of complications, different number of adjustments and time of follow-up and absence of randomized studies. The authors concluded that despite the limitations that studies available were exclusively descriptive and the follow-up was limited, literature findings confirmed ATOMS was more effective, with higher patient satisfaction and better durability than ProACT to treat male SUI.