We report a case and surgical technique of successful sling suspension of insufficient efferent limb of continent urinary reservoir, which has occurred urinary incontinence. A 64-year-old male, who received radical cystectomy with continent urinary reservoir, had been suffered urinary incontinence from the reservoir about one year after surgery. Various procedures, such as the repair of the efferent limb of the reservoir, addition of the ileal patch, instillation of scopolamine, oxybutynin into the reservoir and an injection of GAX collagen in the efferent limb, were not effective for his urinary incontinence. Finally, anti-incontinence procedure of sling at an efferent limb using abdominal rectus muscle fascia was employed and obtained a continence for 2 years after operation. The principle of this surgery is same with that of sling suspension for female stress incontinence. It is advisable for the incontinent urinary reservoir when it has an enough length of efferent limb.