For Patients · University Urology, PC
Hydrogel Rectal Spacer (Barrigel / SpaceOAR) — Preparation & Recovery
What to expect before and after placement of a hydrogel rectal spacer prior to prostate radiation therapy.
About the Procedure
What a Hydrogel Spacer Does
Barrigel and SpaceOAR are injectable hydrogel spacers placed between the prostate and rectum before radiation therapy. By creating a temporary physical separation of approximately 1–2 cm, the spacer reduces rectal radiation dose and the risk of rectal side effects. The gel is bioabsorbable and naturally dissolves over 6–12 months after radiation is complete.
Why it matters
The rectum sits directly behind the prostate. Without a spacer, it receives a meaningful radiation dose, which can cause bowel urgency, rectal bleeding, and other side effects.
The procedure
Hydrogel is injected through the perineum into the space between the prostate and rectum under ultrasound guidance, in the office under local anesthetic with optional light sedation.
Timing
Placement must occur before radiation planning begins. Timing is coordinated with your radiation oncologist — allow 1–2 weeks between placement and the start of radiation.
Before Your Procedure
How to Prepare
Bowel prep the night before
Use a Fleet enema the evening before your procedure to clear the lower rectum. This allows clear ultrasound visualization during placement. Follow instructions exactly as provided at scheduling.
Take your prescribed antibiotic
An antibiotic will be prescribed. Take it as directed.
Arrange a driver
You must have someone drive you home. Sedation may be used and the procedure site is uncomfortable for a few hours afterward.
Coordinate timing with radiation oncology
Spacer placement must occur before your radiation planning CT or MRI. Confirm the timing with both our office and your radiation oncologist before scheduling.
Blood Thinner / Anticoagulation Medications
Contact your prescribing physician before stopping any blood thinner or anticoagulant. Do not stop these medications without medical guidance, particularly if you are on anticoagulation for a high-risk condition such as atrial fibrillation, a mechanical heart valve, or a recent blood clot.
- Aspirin — hold 7 days
- Clopidogrel (Plavix) — hold 5–7 days
- Apixaban (Eliquis) — hold 48 hours
- Rivaroxaban (Xarelto) — hold 48 hours
- Warfarin (Coumadin) — contact prescribing physician for INR guidance
After Your Procedure
Recovery & What to Expect
Normal after spacer placement
Most patients return to normal activity within 1–2 days. Avoid strenuous exercise or heavy lifting for 48 hours.
Call us if you experience:
Call (865) 305-9254. After hours, follow prompts for on-call provider.
Common Questions
Frequently Asked Questions
How long does the spacer stay in place?
The hydrogel naturally absorbs and disappears over 6–12 months after radiation is complete. No removal procedure is needed.
Will I feel the spacer during radiation?
Most patients adapt within 1–2 weeks and do not notice the spacer during daily activities or radiation sessions. Some patients are initially aware of a mild rectal fullness that fades.
Who coordinates timing between urology and radiation oncology?
Both offices will coordinate, but confirm the sequence with your urologist and radiation oncologist before scheduling to ensure placement occurs before your radiation planning imaging.
Questions Before Your Hydrogel Spacer Procedure?
Send a Klara message or call us. Our team is happy to walk you through what to expect.