Abstract Rectoprostatic fistula is a rare complication of prostatectomy by any route including transurethral resection. Occasionally a fistula occurs congenitally or as a result of pelvic trauma. Five patients with rectoprostatic fistulas (4 post-prostatectomy, 1 traumatic) were repaired peranally using a full-thickness local flap of anterior rectal wall. The repair was protected by sigmoid loop colostomy. Primary healing occurred in all 5 patients. Anal and urinary continence are normal following colostomy closure in 3 patients. Two patients died of unrelated causes before colostomy closure.