Aim: To determine the impact of rectus fascial sling suspension at the time of radical retropubic prostatectomy (RRP) on postoperative continence status. Patients and Methods: A total of 86 patients underwent RRP for clinically localized prostate cancer. Out of 86 patients, a rectus fascial sling procedure was incorporated into RRP in 40 randomly selected patients (group 1). The remaining 46 patients underwent standard RRP without any suspension operation (group 2). Results: The incontinence rates were 17.5 and 43.5% for groups 1 and 2, respectively (p = 0.010). Incontinence degrees for each group were statistically significant (p = 0.03). The mean time to achieve full continence was 1.4 +/- 2.2 (0-11) and 3.8 +/- 3.8 (0-12) months for groups 1 and 2, respectively (p = 0.026). Conclusion: Our results showed that incorporation of an anterior rectus fascial sling into RRP is a reasonable and efficient way of achieving improved rates of postoperative continence. Copyright (C) 2009 S. Karger AG, Basel