Anaphylactic shock during SpaceOAR Vue hydrogel procedure

Lauren Nesi; Paramjot Gogia; Aishwarya Navalpakam; Nitin Vaishampayan; Conrad Maitland

doi:10.1016/j.eucr.2024.102870

Anaphylactic shock during SpaceOAR Vue hydrogel procedure

Urol Case Rep. 2024 Oct 20:57:102870. doi: 10.1016/j.eucr.2024.102870. eCollection 2024 Nov.

Authors

Lauren Nesi¹, Paramjot Gogia^{1

2}, Aishwarya Navalpakam³, Nitin Vaishampayan⁴, Conrad Maitland¹

Affiliations

¹ Department of Urology, Detroit Medical Center, 4160 John R St., Harper Professional Building, Suite 1021, Detroit, MI, 48201, United States.
² Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
³ Division of Allergy, Immunology and Rheumatology, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, United States.
⁴ Department of Oncology, Division of Radiation Oncology, Barbara Ann Karmanos Cancer Institute, 4100 John R St, Detroit, MI, 48201, United States.

Abstract

In this report, we present a unique and rare case of an intraoperative anaphylactic shock leading to cardiac arrest during the SpaceOAR Vue™ hydrogel procedure in a 70-year-old patient undergoing External Beam Radiation Therapy (EBRT) for advanced localized prostate cancer. To our knowledge, this is the first urologic case report documenting this adverse reaction associated with the placement of the SpaceOAR Vue product. We discuss the possible culprits, including the hydrogel's polyethylene glycol (PEG) and iodine content, perioperative antibiotics, and local lidocaine anesthetic, and propose relevant considerations for clinicians administering rectal hydrogel spacers.

Keywords: Anaphylaxis; Hydrogel; Polyethylene glycol (PEG); Prostate cancer; SpaceOAR Vue.

Publication types

Case Reports