Peer-reviewedCC BY-NC-NDInternal Medicine
Fournier's Gangrene Following Hydrogel Spacer-related Rectal Ulcer and Fistula in a Patient Undergoing Radiation Therapy for Prostate Cancer
Abstract
Hydrogel spacers are commonly used to reduce rectal toxicity during radiation therapy for prostate cancer. Although generally safe, rare, serious complications may occur. We report the case of a man with diabetes and renal failure who developed a refractory rectal ulcer and fistula five months after spacer placement, followed by Fournier's gangrene. The patient recovered following surgical drainage and antibiotic therapy. This is the first reported case of Fournier's gangrene following hydrogel spacer insertion. Spacer-related rectal wall infiltration might have contributed to this finding. Clinicians should recognize such adverse events and consider early intervention in high-risk patients presenting with hematochezia or perineal symptoms.
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BibTeX
@article{kimura2026fourniers,
title = {{Fournier's Gangrene Following Hydrogel Spacer-related Rectal Ulcer and Fistula in a Patient Undergoing Radiation Therapy for Prostate Cancer}},
author = {Kazuya Kimura and Kenta Watanabe and Mizuki Kobayashi and Keisuke Okubo and Hiromi Sato and Shintaro Narita and Yuki Wada and Satoshi Kumagai and Kimihiko Sato and Sho Fukuda and Tatsuki Yoshida and So Kodama and Yohei Saruta and Ryo Abe and Yosuke Shimodaira and Tamotsu Matsuhashi and Junichi Arita and Naoko Mori and Hiroshi Nanjo and Tomonori Habuchi and Katsunori Iijima},
journal = {Internal Medicine},
year = {2026},
month = jul,
doi = {10.2169/internalmedicine.6449-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/14/65_6449-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Fournier's Gangrene Following Hydrogel Spacer-related Rectal Ulcer and Fistula in a Patient Undergoing Radiation Therapy for Prostate Cancer
AU - Kazuya Kimura
AU - Kenta Watanabe
AU - Mizuki Kobayashi
AU - Keisuke Okubo
AU - Hiromi Sato
AU - Shintaro Narita
AU - Yuki Wada
AU - Satoshi Kumagai
AU - Kimihiko Sato
AU - Sho Fukuda
AU - Tatsuki Yoshida
AU - So Kodama
AU - Yohei Saruta
AU - Ryo Abe
AU - Yosuke Shimodaira
AU - Tamotsu Matsuhashi
AU - Junichi Arita
AU - Naoko Mori
AU - Hiroshi Nanjo
AU - Tomonori Habuchi
AU - Katsunori Iijima
PY - 2026
DA - 2026/07/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.6449-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/14/65_6449-25/_article
AB - Hydrogel spacers are commonly used to reduce rectal toxicity during radiation therapy for prostate cancer. Although generally safe, rare, serious complications may occur. We report the case of a man with diabetes and renal failure who developed a refractory rectal ulcer and fistula five months after spacer placement, followed by Fournier's gangrene. The patient recovered following surgical drainage and antibiotic therapy. This is the first reported case of Fournier's gangrene following hydrogel spacer insertion. Spacer-related rectal wall infiltration might have contributed to this finding. Clinicians should recognize such adverse events and consider early intervention in high-risk patients presenting with hematochezia or perineal symptoms.
SN - 1349-7235
SN - 0918-2918
ER -