Successful treatment of rare vaso-vesical fistula with minimally invasive measures despite prior history of radiotherapy: a case report.

Stereotactic body radiotherapy (SBRT) for prostate cancer is a generally well-tolerated treatment but can rarely lead to complications such as fistula formation. We report a 69-year-old male on maintenance ibrutinib for chronic lymphocytic leukemia who developed a fistula between his bladder and vas deferens in the setting of ascending scrotal infection. Despite his prior history of SBRT, the fistula was successfully treated with minimally invasive measures. A combination of abscess debridement, urinary diversion, and broad-spectrum antibiotics helped to achieve fistula resolution. The unique presentation described herein highlights the importance of early aggressive intervention for source control and infection management in patients with complex pelvic infections post-SBRT.