Objective To explore the effects of nursing intervention guided by stress coping theory on self-care ability in patients with urinary incontinence (UI) after prostate cancer (PCa) surgery. Methods A total of 75 PCa patients complicated with postoperative UI treated at Xinjiang Production and Construction Corps Hospital from February 2021 to February 2025 were retrospectively enrolled. Subjects were assigned to a control group (37 cases) and an observation group (38 cases) based on different nursing schemes. The control group received conventional nursing care, whereas the observation group was provided with stress coping theory-based nursing intervention on the basis of routine care. The intervention lasted for 2 months in both groups. The severity of UI, self-care ability and quality of life were compared before and after intervention. Results Before intervention, no statistically significant intergroup differences were found in the severity of UI, scores of self-care indicators and quality-of-life indicators (all P＞0.05). After intervention, the observation group achieved better improvement in urinary incontinence symptoms (P＜0.05), and obtained remarkably higher scores of self-care and quality of life than the control group (all P＜0.05). Conclusion Nursing intervention based on stress coping theory can effectively relieve urinary incontinence, improve self-care ability and quality of life for PCa patients after surgery, which possesses high clinical application value.