Abstract
INTRODUCTION: SpaceOAR is a hydrogel spacer widely used to protect the rectum from radiation toxicity during prostate cancer treatment. Reported here is a case in which an abscess that developed following SpaceOAR placement was successfully treated with laparoscopic fenestration. CASE PRESENTATION: A 70-year-old man with localized prostate cancer undergoing a radiation therapy course developed an abscess at the SpaceOAR placement site 76 days after implantation. Antibiotic therapy and percutaneous drainage were ineffective; thus laparoscopic abscess fenestration was performed. Abscess size reduction was noted, leading to clinical improvement and a favorable course. CONCLUSION: This is the first known reported case of laparoscopic abscess fenestration for a SpaceOAR-related abscess and the findings highlight the need to include abscess formation as a differential diagnosis even after more than 2 months following placement. Furthermore, this case indicates laparoscopic fenestration as a viable treatment option for a rectal spacer-related abscess unresponsive to antibiotics or percutaneous drainage.