A novel technique of combined radical retropubic prostatectomy and restorative proctosigmoidectomy is described, and indications and expected complications are discussed. It is offered as an alternative to total pelvic exenteration for patients with carcinoma of the rectum exhibiting isolated extension to the prostate gland or seminal vesicles. This procedure obviates the need for urinary and fecal diversion and provides excellent exposure for optimal rectal dissection. Thus, it offers the opportunity for improved functional results without compromising the principles important for local tumor control.