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For radical prostatectomy these include erectile dysfunction and incontinence and for RT one of the main side effects is rectal toxicity from radiation exposure, owing to proximity to the prostate [4,5]. In addition, radiation margins of up to 10?mm around the prostate are required, owing to prostatic motion during treatment, to ensure that the entire gland receives the full dose of radiation [6,7]. Because of the anatomical proximity to the sensitive rectal mucosa, the rectum is commonly defined as the dose-limiting structure for prostate radiotherapy [8]. Storey et?al. [9] reported that there were significantly more late rectal complications, such as bleeding, when 25% of the rectum received ��70?Gy. To overcome this issue, several investigators have evaluated different materials, injected transperineally, to create space between the prostate and the rectum, including a blood patch [10], hyaluronic acid [11,12] and collagen injections [13]. Although http://www.selleck.cn/products/Bleomycin-sulfate.html these materials have been shown to reduce the amount of radiation http://www.selleckchem.com/products/MG132.html to the rectum, each has certain drawbacks such as short persistence, degradation during RT and a non-uniform distribution. To address some of these drawbacks, a polyethylene glycol (PEG)-based hydrogel system (SpaceOAR? System, Augmenix, Waltham, MA, USA) has been developed to temporarily create space between the rectal wall and the prostate during RT, thereby reducing the amount of radiation to the anterior rectum. The hydrogel spacer is a synthetic PEG-based material that is absorbable, water-soluble, non-toxic and non-immunogenic. It remains in place for 3 months, and then undergoes hydrolysis, liquefies, and is absorbed and cleared from the body in ?6 months via renal filtration (Fig.?1). In situ polymerizing hydrogels were evaluated as prostate�Crectum spacers in cadavers, showing satisfactory hydrogel distribution in all cases [14]. The mean (sd) prostate�Crectum separation was 12.8 (1.2) mm. Overall, a prostate�Crectum separation of 10?mm was found to be sufficient to reduce the http://www.selleckchem.com/products/Rapamycin.html mean volume of the rectum receiving at least 70?Gy (rectal V70) by 83.1% (P