Bladder and Bowel Preparation for prostate radiation

I survived 35 killer radiation treatments. You are in for a bad ride. Any bit of being humble or wanting not to be embarrassed being seen naked are gone. You will get 3 tattoos to begin on the first trial run, The computer will line you up the same each time. You will be in only a gown. The amount of fluid you will drink is a lot. Bladder scan to see how full you are. If not full enough, go back to the dressing room and drink more. Sometimes you will drink so much the nurse will put a clamp on your penis so you stop leaking. Then the real fun begins. I can't describe what it feels like to get the probe inserted in your rectum and them filled up. Imaging the biggest poop ever and double it. The pain only last about 15 minutes. The amount of radiation and the diameter of the area killed will change each time. I think I glowed sometimes and was really HOT when it was done. The nurses will get out of your way when done and you will sprint to the bathroom. Your 1 to 10 pain scale will change. You will have bad scans and really bad scans, changes every time. Good luck.

@upnort, what type of radiotherapy will you be getting? I completed 28 external Proton beam treatments at Mayo Phoenix last year. Daily regimen was to simply drink one 16 oz bottle of water 1-hour before checking in for each treatment. I had fiducial markers imbedded in my prostate as well as SpaceOAR implant in advance of starting the Proton therapy.

Have completed 19 of 29 proton treatments and had Space OAR. Only preparation each day is filling bladder with water one hour before treatment. Most of the time I am in the range and maybe 4 times have had to drink more and wait 10- 20 minutes before treatment and a few times have had to drain some off. Slightly uncomfortable not being able to pee when you choose to but easily tolerated. I try to have a bowel movement before I go so as not to have excess gas ( eat prunes in the morning)that has to be released by the nurse. So far, I am batting 1,000.
Preparation is actually easily done.

Addendum: Have read about or talked to close to men who have had proton therapy and not once has anyone indicated an enema as part of prep.

I will be having the traditional external beam radiation therapy. I, too, had the SpaceOAR implant as well as the fiducial markers. It sounds like you did not have to empty the bowels each day w/emema, and your water intake was half of my recommended volume. I wonder why the difference? My friend also had Proton therapy at the Phoenic Mayo and experienced no pain during each of his 28 treatments. He has been cancer -free for ten years. I am hoping for a positive outcome even with these differences.
Thanks for your input.

Perhaps there is a difference in protocol depending on the number of treatments, methodology (proton vs traditional radiation aka photon radiation) and the location of your treatment. (For example: I believe there is some difference btw Mayo MN and Mayo AZ; both do proton beam treatment.)
I have detailed my experience here: https://connect.mayoclinic.org/discussion/rising-psa-2years-after-radical-prostatectomy/?pg=4#comment-708134
Briefly, I had five Proton Beam treatments (over two weeks) in Feb 2020 at the Mayo Clinic in Rochester MN. I had the SpaceOar spacer and fiducial (carbon?) marker placement about a week before treatment.
I had an enema before each treatment at an area in Mayo focused on that. I didn't find it embarrassing, nor did I have to insert the enema prep myself (a friend at home getting 25 traditional xray treatments had to handle his own enema each day - it wasn't always easy or 'fun'). I don't remember any requirement to drink a large quantity of water. There was no insertion of anything into my rectum (for treatment).

Not all facilities are equal or take the same approach for the same type of therapy. Loma Linda is one of the oldest hospitals providing proton beam treatment. I think the method of delivery may have changed but I believe they still use a 25 treatment protocol. It may also be worth saying that not all facilities charge the same amount for (nearly) identical therapies. Its my casual impression that Mayo MN may charge very low amounts for Proton Beam Therapy - maybe due in part to donors with deep pockets.

I had exactly what you are experiencing but no required enema. The OAR did its job, thank goodness. Best of luck to you.