SpaceOAR causing issues

The placement of my Space OAR failed in October of 2022 and created an ulcer in my anal canal wall. This delayed me getting my proton radiation. I just had my second sigmoidoscopy last week and the ulcer is now healed. I told my urologist at OU back in October of 2022 I will not do another gel placement since the first placement failed. Now waiting to get my proton radiation.

jimcinak. I agree that this is interesting, so I'll describe what I know. At UCLA last summer, I was set up for "hydrogel" placement a week or two before the scheduled radiation treatment. "SpaceOar" was not mentioned, but I note that SpaceOar's web site says it is hydrogel. What was described for me was "hydrogel" placement, but I don't think it was SpaceOar. They said the hydrogel was temporary and would dissipate and disappear within 6 months. I experienced no discomfort from the gel, or any sensation it was there.

For the placement, I declined anesthesia or drugs since I was fascinated as to the mechanics of getting a solid into my body non-invasively. Be careful what you wish for. I find out it involves inserting a large needle in the small space between my scrotum and anus....Yikes. How do you do stick a needle there without damaging prostate, rectum, etc.? Quite an "Ah Hah" moment. Turns out the device was just like something you would get at Home Depot for applying a two part epoxy, i.e. a twin tube plunger device where the two parts combine just as just at the injection point, just below my scrotum (I believe); she had to move the family jewels around a few times. Boy, the small needle numbing in three places by a pretty young physician in preparation for the large needle was a humbling and uncomfortable experience (in more ways than one). But the numbing was effective so no white knuckles when she turned to the big guy. Big needle guidance was by ultrasound I think. How did it feel? After the discomfort of the numbing, in places even my wife has not gone, the subsequent sensation was some pressure an a lot of heat. The heat hurt for about 10 minutes. Clearly, this was the heat of the gel formation from the two components. She had not warned me about that. They then left me alone for about a half hour.

So, was it necessary or effective? I was shown the before and after imaging a few days later. My very large prostate was pressed tight against the prostate. Effective radiation of the prostate could not have been able to avoid rectal damage. The hydrogel now separated the two by maybe an inch. Awesome. Thank you for medical progress. Clinically, I have not experience any side effects from the radiation, so I thank the skill of the doctors. Perhaps the skill of the doctor doing the placement is a factor in what patient's experience? However, I do hope she doesn't spend all her time working one foot or less from a male anus.

I would guess you had a transrectal biopsy with your comments about the needles where your wife has not gone. I had a transperineal biopsy and it was not bad as they numbed me very well. I plan on getting the SpaceOar at Mayo Phoenix as I have a very large prostate.

My ulcer was not healed after four months. I will schedule another check in the next two months. I had a colonsocpy in October and they saw the ulcer after I requested they report back to me on that. They took a biopsy and it was negative.

Mike, Sorry, this is a thread on preparing for radiation treatment of an intact prostate already diagnosed with prostate cancer. Nothing to do with biopsies.

drj, I think Mike was suggesting the possibility that the infection might have come from a transrectal biopsy vs transperineal biopsy rather that the hydryogel/SpaceOar insertion. Might be somewhat clearer if imbimbo had mentioned the time spread between biopsy and treatment.

I had perineal. Two weeks after it was inserted I had the symptoms of an infection but the doctors did not diagnose it until a full month after the infection started. I never started radiation

Just for clarity in the comments: there are needle biopsies, and there are needle hydrogel placement. The real estate is usually quite different. I believe most prostate biopsies are transrectal. The biopsies are then used to make the diagnosis and inform potential treatments.
Once the decision is to treat by radiation, some people precede that radiation by a couple of weeks with hydrogel insertion to minimize radiation damage to the colon, etc. Hydrogel placement is with an injection by an ultrasound guided needle in the area between the scrotum and the anus. This area is also known as the perineum. Numbing of the area immediately before the insertion was done by three injections.
It may be possible to do perineal biopsies of the prostate, it's just that I'm not aware of any.

I had two biopsies : one to confirm cancer and the second was a biopsy of the ulcer in my rectum caused by the hydrogel insertion. The rectal biopsy was done during a colonoscopy and had nothing to do with the prostate biopsy