Prostate Brachytherapy with Perirectal Spacing in the Management of Prostate Cancer

Case Record:

• Case 1: SpaceOAR™ Hydrogel application with a permanent seed implant Brachytherapy procedure under general anesthesia for a patient with favorable intermediate prostate cancer

• Case 2: SpaceOAR™ Hydrogel application with a permanent seed implant Brachytherapy procedure under general anesthesia for a patient with favorable intermediate prostate cancer

Technique description:

1. Minimally Invasive procedure to provide space between the prostate and anterior wall of the rectum prior to radiation therapy for prostate cancer

2. Transrectal ultrasound visualization to guide the procedure

3. Hydrodissection to open the space prior to the SpaceOAR Hydrogel injection

4. Injection of the SpaceOAR Hydrogel between the prostate and rectum

Procedure steps:

• Patient under IV anesthesia; patient positioning

• LDR Brachytherapy procedure

• Take time to ensure needle placement below the Denonvilliers fascia

• Importance of excellent transrectal ultrasound quality In both the axial and sagittal views 

• Importance of the hydrodissection procedure and aspiration

• SpaceOar Hydrogel injection anatomical location and technique

Training Objectives:

• Patient under IV anesthesia; patient positioning

• LDR Brachytherapy procedure

• Importance of excellent transrectal ultrasound quality in both the axial and sagittal views 

• Importance of the hydrodissection procedure and aspiration

• Proper SpaceOAR Hydrogel injection anatomical location and technique