Closing the Gap in Post-Prostatectomy Incontinence Care: A Single-Center Analysis of Patient-Reported Outcomes

Authors

• Aidan J. Kennedy, Corewell Health East Resident
• James Um, Oakland University William Beaumont School of Medicine Medical Student
• Bennett Hendricks, Oakland University William Beaumont School of Medicine Medical Student
• Iulia Dobrin, Oakland University William Beaumont School of Medicine Medical Student
• Bernadette M M Zwaans, Corewell Health East
• Frank N. Burks, Corewell Health East

Document Type

Conference Proceeding

Publication Date

5-2026

Publication Title

Journal of Urology

Abstract

NTRODUCTION AND OBJECTIVES: Stress urinary incontinence (SUI) is a common and distressing condition affecting men after prostatectomy, with reported rates of 10e22% at one year after surgery. AUA Guidelines recommend pelvic floor physical therapy (PFPT) and permit surgical intervention as early as six months post-prostatectomy if bothersome SUI persists. Despite this, only 3e5% of patients undergo surgery. This study evaluated the prevalence and severity of post-prostatectomy urinary leakage using patient-reported surveys and examined the relationship between urinary incontinence severity and treatment received. METHODS: A retrospective review was conducted of post-prostatectomy patients enrolled in the Michigan Urological Surgery Improvement Collaborative (MUSIC) database at a single institution from June 2015eMay 2024. Inclusion criteria were men ≥18 years with prostate cancer who underwent radical prostatectomy and completed at least one post-operative MUSIC/EPIC-26 survey. Demographics, comorbidities, PFPT completion, and surgical interventions for SUI were extracted from the EMR. Patients were classified as continent or incontinent based on EPIC-26 urinary domain scores. Statistical analyses compared outcomes between these groups. RESULTS: We reviewed 325 patients (mean age at prostatectomy 64.3, mean BMI 31.4) with a median follow-up survey at23 months postop. Overall, 244 patients (75%) reported some degree of urinary leakage: 121 (37%) had worsening or de novo leakage, 78(24%) transient, resolving leakage, and 45 (14%) pre-existing leakage that persisted postoperatively. Fifty-five (17%) reported no leakage. The EPIC-26 urinary continence score averaged 49 in patients with persistent/worsening leakage versus 91 in those with resolved/no leakage (p< 0.001). PFPT was performed by 30% of patients with persistent/worsening leakage compared to 13% with resolved/no leakage (p< 0.001). Only eight patients (2.5%) underwent surgical management (5 artificial urinary sphincters, 2 male slings, 1 both),with a median interval of 712 days from prostatectomy to surgery(range 230-1650 days).CONCLUSIONS: Post-prostatectomy incontinence remains under-recognized and undertreated. Patient-reported EPIC-26 survey data reveal higher rates of persistent or worsening urinary leakage than previously reported. Despite guideline-supported options, few patients pursue surgical intervention. Greater patient and provider education is needed to promote timely and proactive management of post-prostatectomy stress and urge incontinence.

Volume

215

Issue

5S

First Page

e199

Last Page

e199

Recommended Citation

Kennedy AJ, Um J, Hendricks B, Dobrin I, Zwaans BMM, Burks F. Closing the gap in post-prostatectomy incontinence care: a single-center analysis of patient-reported outcomes. J Urol. 2026 May;215(5S):e199. doi:10.1097/01.JU.0001191316.72449.22.10

Comments

American Urological Association Annual Meeting, May 15-18, 2026, Washington, DC

DOI

10.1097/01.JU.0001191316.72449.22.10