That’s the “operator error” that I mentioned earlier. The spacer gel is injected directly into the perirectal space between the prostate and the rectum.

As is indicated in the SpaceOAR Instructions for Use (https://contentstaging.spaceoar.com/assets/LCN-80-3101-001-en-Rev-D_SpaceOAR-System-10mL-IFU-CAN.pdf), the
SpaceOAR needle should be inserted under ultrasound guidance to maintain needle tip visibility and prevent rectal wall penetration. In the US Clinical Study inadvertent rectal wall needle penetrations were experienced in 1.4% of subjects.

So, as long as his doctors at Loma Linda injected it correctly - and don’t penetrate the rectal wall - there was no risk for rectal bleeding.

I agree with @brianjarvis. The expertise with technique is really important. Doctors, in general, are not anxious to talk about mistakes or bias’s they may have personally or professionally.

The use of spaceoar is still used at centers of excellence. The separation between the rectum and the prostate when radiation is applied can impact side effects from radiation exposure, and therefore quality of life.

Isn’t Loma Linda supposed to be one of the CoE? I expect that their urologists must do this all the time. Is this an inevitable 2% error rate. If not, how do we avoid these errors?