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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.
Replies to "Just for clarity in the comments: there are needle biopsies, and there are needle hydrogel placement...."
Rectum insertion of spaceoar is what I had. It gives 1/2 inch extra spacing between rectum and Prostate. I had my radiation and no rectum issues. Finished radiation on Valentine’s Day.
The percentage is quoted on the spaceoar site in terms of bad issues and they are very low. If I had to make that decision again, I would do it again.Orlando health cancer had a spaceoar technician in the operating room and they put me out for it.
By the way, spaceoar customer support will spend time with you on the phone if you want them to answer questions. It was helpful to me.
@drj I'm proof that perineal biopsy is a thing. After having 3 transrectal biopsies that came back negative for cancer all the time having my PSA rising, Mayo Rochester did a perineal biopsy and found the cancer 4 - 3 Gleason score. had Proton SBRT 5 times over 10 days in September of 2020.
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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