Stress urinary incontinence (SUI) is common following prostate treatment especially for radical prostatectomy and radiation therapy in the prostate cancer setting. Post-prostatectomy SUI tends to occur earlier but can improve with time, while those with radiation-induced SUI often present later and are more likely complex. While conservative measures such as pelvic floor exercises and lifestyle modifications should be tried before surgical interventions, those with moderate to severe SUI are less likely to improve and may wish to consider definitive surgery. Nonetheless, it remains the duty of care for the surgeon to discuss with the patient whether to wait longer in the hope that further improvement in urinary continence will occur. In contrast, there are no clear guidelines for patients who developed non-prostate cancer-related SUI, and most would agree that urinary reconstructive surgery is likely more effective (and challenging) in this complex population.