SpaceOAR (Rectal Spacer) for Prostate Radiation Therapy

Radiation therapy can be used to treat prostate cancer. SpaceOAR is a gel that may be used with treatment to lessen the effects of radiation to the rectum. 

What is SpaceOAR?

SpaceOAR is a gel-like substance called hydrogel. It makes a temporary space between the rectum and the prostate. This space lessens the effects of radiation to the rectum. SpaceOAR stands for “Spacing Organs at Risk.” The hydrogel is made up of two liquids that when put together form a soft gel that is mostly water. The hydrogel is safe to use in the body and has been FDA approved in the United States. It is put into the body using a needle and stays in place for about 3 months. This is long enough to get a course of radiation therapy. The gel then turns to liquid and is absorbed by the body. Your body gets rid of it through your urine in about 6 months. 

How do I prepare for the procedure to place the SpaceOAR?

There are a few things you will need to do to prepare:

• Start taking an antibiotic the day before your procedure and continue for 3 days.
• On the morning of your procedure, you may eat a light breakfast and drink water normally.
• To help reduce gas and stool in your rectum, you may need to do an enema at home. Your care team should give you instructions on when to do this.
• If you are taking a blood thinner (such as coumadin, aspirin, or NSAIDs), your provider may ask you to stop taking it before the procedure.

It is important to follow the directions given to you to get ready for the procedure. If you have any questions, you should contact your provider.

What can I expect with the procedure?

The SpaceOAR placement is done as an outpatient procedure in a hospital, surgery center, or your provider’s office. It is often done at the same time fiducial markers are placed and before your CT Simulation. It takes about 30 minutes, but you will be in the clinic for about 60 minutes. This procedure is often done with local anesthesia (medication that is used to numb the area). The procedure can also be done under regional or general anesthesia, where you are sedated or asleep. If you are sedated, you will need to have someone drive you home. Your provider will talk to you about your options.

About 30 minutes before your procedure, you may be given medication to help with anxiety and medication for mild pain relief. During the procedure, you will be lying on your back with your feet up in stirrups. This is like the position you are in for a prostate needle biopsy. An ultrasound probe will be put in your rectum to help guide the needle. The perineum (the flat skin between your anus and scrotum) will be numbed with medication. Then a needle will be placed into the perineum to inject the rectal spacer gel. You will feel pressure or pinching, but you should not feel major discomfort. You should be able to go back to your normal activities right after the procedure if your provider did not tell you about any restrictions.

What are the possible side effects?

Some possible side effects are:

• Pain and discomfort.
• Needle piercing the bladder, prostate, rectal wall, rectum, or urethra.
• Injection of hydrogel into bladder, prostate, rectal wall, rectum, or urethra.
• Injection of air, fluid, or SpaceOAR hydrogel intravascularly (into the blood vessel).
• Rectal mucosal damage, ulcers, or necrosis (tissue death).

Is SpaceOAR right for me?

SpaceOAR can be used for many men, but it is not for everyone and there are other options. You and your provider should talk about options for your treatment and decide together about the best treatment for you.