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Laparoscopic Fenestration for Abscess Following SpaceOAR Placement-Case Report.

Yuki Matsuo1,2, Kimihiro Shimatani1,2, Toeki Yanagi1

  • 1Department of Urology Hyogo Medical University Nishinomiya Japan.

IJU Case Reports
|December 31, 2025
PubMed
Summary

An abscess developed after SpaceOAR hydrogel spacer placement for prostate cancer radiation therapy. Laparoscopic fenestration successfully treated the SpaceOAR abscess when other methods failed.

Keywords:
SpaceOARabscessprostate cancer

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Area of Science:

  • Oncology
  • Surgical Innovation
  • Radiation Therapy Complications

Background:

  • SpaceOAR hydrogel spacer is utilized to mitigate rectal toxicity during prostate cancer radiation therapy.
  • Abscess formation is a rare but potential complication following SpaceOAR implantation.

Purpose of the Study:

  • To report a case of a SpaceOAR-related abscess successfully treated with laparoscopic fenestration.
  • To highlight laparoscopic fenestration as a treatment option for refractory rectal spacer abscesses.

Main Methods:

  • A 70-year-old male patient with prostate cancer developed a SpaceOAR abscess 76 days post-implantation.
  • Initial treatment with antibiotics and percutaneous drainage proved ineffective.
  • Laparoscopic abscess fenestration was performed for definitive treatment.

Main Results:

  • Laparoscopic fenestration led to significant abscess size reduction.
  • The patient experienced clinical improvement and a favorable outcome post-procedure.
  • This case demonstrates the efficacy of laparoscopic fenestration in managing SpaceOAR abscesses.

Conclusions:

  • Abscess formation should be considered in the differential diagnosis of SpaceOAR complications, even beyond two months post-placement.
  • Laparoscopic fenestration is a viable and effective treatment for SpaceOAR-related abscesses unresponsive to conservative management.
  • This case represents the first reported instance of successful laparoscopic abscess fenestration for a SpaceOAR complication.