Stress urinary incontinence (SUI) is a common consequence of prostate surgery, especially after radical prostatectomy. According to Dr. Melissa Kaufman, a leading reconstructive urologist at Vanderbilt University, its impact on men’s quality of life is profound — and often underestimated.
Dr. Melissa Kaufman
Functional & Reconstructive Urologist, Vanderbilt University Medical Center
“Oncologic control is the top priority in prostate cancer surgery,” Dr. Kaufman explained. “But continence and erectile function are next, and when continence is compromised, the effects are anything but benign.”
Prostate removal results in urethral shortening and bladder neck widening, which may compromise urinary continence and contribute to the development of stress urinary incontinence. While some men recover naturally, many live with leakage for years — sometimes up to five years before seeking help. Why the delay?
“Men often hide it,” Dr. Kaufman said. “They don’t want to disappoint their oncologist or discuss something so personal. But during that time, they pay a heavy price — financially, emotionally, socially.”
A constant, inescapable burden
Urinary leakage is not just a physical inconvenience — it’s a daily reminder of cancer and its aftermath. “It’s a chronic reminder: I’ve had cancer. Every move brings leakage. It erodes confidence, self-image, and a man’s sense of masculinity,” Kaufman noted.
The condition forces lifestyle changes. Men restrict fluids, wear dark clothing to hide stains, and carry extra pads. Many withdraw from activities they once loved — golf, hiking, swimming — because bathrooms aren’t nearby. Even small routines change: “From the second he wakes up, it’s a reminder — bed protection, pads, diapers. And at work, even changing a pad can become stressful.”
Isolation, anxiety, and strain on relationships
Dr. Kaufman frequently sees depression and anxiety tied to SUI: “Men stop doing things they love. They pull away socially, which breeds isolation and weight gain. Intimacy suffers, and that affects partners deeply.”
Family life is disrupted, too. Activities with children or grandchildren — like going to the lake — become off-limits. “The condition impacts everyone in the household because daily routines change. It’s not a solitary problem — it’s a shared challenge,” she said.
Another overlooked consequence is the financial toll: pads, extra clothes, medical visits, lost work time, and even career changes. Men in physically demanding jobs or high-stakes roles feel it most.
“I’ve had CEOs terrified of leaking during presentations,” Dr. Kaufman said. “Factory workers apply for disability because they can’t manage their pads on the job.”
The road back
Despite the challenges, Dr. Kaufman stresses there is hope. Surgical options — such as slings and artificial urinary sphincters — can restore dignity and function. “When men finally have surgery, the most common thing I hear is, ‘I wish I had done this years ago.’”
An exciting development is the ARID II IDE study, sponsored by Levee Medical, now enrolling patients at up to 30 U.S. clinical sites. This pivotal trial evaluates an investigational device, the Voro Urologic Scaffold, a bioabsorbable implant designed to support the bladder neck and preserve urethral length during radical prostatectomy. The study’s objective is to compare the safety and effectiveness of Voro versus standard care in reducing stress urinary incontinence, with outcomes focused on continence rates and quality of life.
For men facing prostate surgery, this research represents hope for fewer complications and faster recovery.
Dr. Kaufman’s advice: “You can regain your quality of life and your dignity. You’ve survived cancer — don’t suffer in silence. There are solutions, and research is advancing fast.”
To learn more, visit clinicaltrials.gov and search ARID II
