Barrigel

Barrigel Rectal Spacer is a soft, biodegradable gel that acts as a temporary spacer between the prostate and the rectum during radiation therapy for prostate cancer. Its purpose is to protect nearby healthy tissue from unnecessary radiation exposure.

Why is a Spacer Used During Prostate Radiation?

The prostate and rectum sit close together, separated by only a thin layer of tissue. During radiation therapy, this closeness makes it difficult to avoid the rectum entirely. Even small amounts of scatter radiation can irritate or damage the rectal lining over time.

A rectal spacer like Barrigel creates a safe, natural buffer zone. This added space allows your doctor to deliver precise treatment to the prostate while protecting surrounding tissue. Barrigel:

• Reduces radiation exposure to the rectum
• Helps protect bowel and bladder function

This separation protects healthy structures. It also makes radiation therapy more comfortable and easier to tolerate.

How Does Barrigel Work?

Barrigel is injected as a liquid that quickly forms a soft, sculptable gel barrier. It is made from a hyaluronic acid-based material. It safely separates the rectum from the prostate by about one centimeter. A protective cushion is created that reduces the amount of radiation reaching the rectum. By limiting rectal exposure, Barrigel helps minimize side effects such as:

• Bowel irritation
• Rectal pain
• Bleeding

Because it can be shaped during placement, your doctor can tailor the spacer to fit your unique anatomy. Once in place, Barrigel stays stable for the full duration of your radiation treatments.

After therapy is complete, the body gradually breaks down and absorbs the gel. It takes several months, but no permanent material is left behind. Most men will never feel the gel and can go about their normal activities soon after placement.

How is Barrigel Placed?

The Barrigel procedure is performed with anesthesia to keep you comfortable and typically takes less than 30 minutes.

Using ultrasound guidance, the doctor carefully inserts a small needle through the skin between the scrotum and anus. The needle is used to inject and shape the gel between the prostate and rectum. Following the placement, you can expect:

• Mild soreness or pressure in the pelvic area for a short time
• Little or no awareness of the gel once it’s in place
• Quick recovery, often returning to regular activities within a day

Radiation treatment usually begins within a few days after imaging confirms that the spacer is positioned correctly.

Does Barrigel Have Side Effects?

Short-term side effects may appear within the first few weeks after treatment, but usually improve on their own. These can include:

• Temporary soreness or pressure in the rectal area
• Changes in bowel habits, such as going more often or having looser stools
• Occasional diarrhea
• Minor spotting or bleeding from the rectum
• Needing to urinate more often or more urgently than usual
• Mild irritation or infection where the injection was given

What Are the Benefits of Barrigel?

Barrigel helps make prostate cancer radiation therapy safer, and the benefits include:

• Lower risk of rectal discomfort, bleeding, or bowel changes
• Better preservation of bowel and bladder function
• Improved ability to tolerate treatment with fewer interruptions

How Does Barrigel Differ from Other Spacers?

While all rectal spacers serve the same protective purpose, Barrigel offers a few unique advantages. It can be shaped during injection to achieve consistent spacing, helping your doctor prevent uneven protection. It also maintains its position and shape until it is naturally absorbed.

Barrigel is visible on ultrasound, CT, and MRI scans. This allows your medical team to confirm proper placement throughout your course of treatment.

Who May Benefit from Barrigel?

Barrigel is typically recommended for men with localized prostate cancer who are receiving external beam radiation therapy or stereotactic body radiation therapy (SBRT). It may be an option for patients who:

• Have a healthy rectal wall and no significant scar tissue
• Are planning radiation as their primary treatment for prostate cancer
• Want to reduce the risk of bowel side effects during and after therapy

Barrigel may not be suitable for individuals with:

• Severe rectal scarring
• Infection
• Previous extensive pelvic surgery

Your doctor will review your medical history and imaging to determine if placement is safe and can offer you an effective way to protect your healthy tissue during prostate cancer radiation therapy.

Barrigel FAQs

1. Can Barrigel be used with all types of prostate radiation therapy?

Barrigel is compatible with several forms of external beam radiation. It is not typically used for brachytherapy, where radioactive seeds are implanted directly into the prostate.

2. Will Barrigel affect my PSA test results?

No. Barrigel does not interfere with prostate-specific antigen (PSA) testing or alter how your doctor monitors your cancer response after treatment.

3. Will I need a follow-up procedure or removal?

Barrigel naturally absorbs over time, so no follow-up procedure is needed for removal.

Trey Jones, MD