Brachytherapy/Radioactive Seed Implant Instructions
What is Brachytherapy?
Brachytherapy is an outpatient technique that implants radioactive “seeds” directly into the prostate. These seeds deliver about 90% of their radioactivity over approximately six months. One year after implant, the radioactivity has gone through a process of natural decay. Your doctors complete the procedure in the operating room. This operation does not require a surgical incision. Instead, thin needles are passed into the prostate gland through the skin between the scrotum and the anus. An ultrasound probe is kept in the rectum to assist in visualization of the implantation of each seed. Once all seeds are placed the devices are removed. After the procedure, a catheter may or may not be present to temporarily drain the bladder.
An anesthesiologist makes the choice of anesthesia. This doctor makes the decision based upon your general physical and medical history. You may either have general or spinal anesthesia. You may feel somewhat dizzy and/or sleepy after surgery. Anesthesia can remain in your system for up to 24 hours. As a result you should not plan to operate heavy machinery, drive a motor vehicle, consume alcohol, or make any important business decisions for the next 24 hours. For the remainder of the day try to rest as much as possible.
There is very little discomfort immediately after the implant. An ice pack may be used between your legs to help reduce swelling in the implant area. Ice should remain on for 20 minutes and then removed for 20 minutes. You may want to use this for 24 to 48 hours for comfort. If you are given a prescription for discomfort by your doctor please take as directed.
Following the implant you may notice some blood in your urine. This is normal and should subside in approximately two to three days. If the bleeding persists beyond this or if you begin to pass blood clots, you should call your doctor. It is not unusual to experience burning with urination. Drink plenty of fluids to help flush the bladder and notify your doctor or go to the emergency room if you are unable to pass your urine.
Although it is rare, a seed may be lost while urinating. The seed is gray/silver in color. If a seed is passed it usually occurs within the first few days following the implant .It is important to strain your urine for the first three days and if a seed is passed it must be disposed of properly. Use a damp Q-tip to assist transporting the seed in to the special container provided. Do not touch the seed with your fingers. The seed should be returned to your doctor.
In the similar manner, a seed may be rarely passed with intercourse. For this reason, it is recommended that a condom be used during intercourse for the first few weeks following the procedure so that any seed passed can be retrieved. It is common for the ejaculate to be dark brown or black for many weeks following the procedure. This is normal secondary to the bleeding that might have occurred at the time of surgery. It is not unusual to have small amount of blood present after having a bowel movement for the first few days after the procedure.
You should avoid heavy lifting or strenuous activity for the first two days once you are home. After that, you may return to your normal activity level. Dangers of radiation exposure to people in close contact with you are very low. Nevertheless, very small amounts of radiation can reach other people from either a seed being passed in the urine or by a tiny amount escaping from the prostate and traveling through the air. Small children and pregnant women may be sensitive to the effects of radiation and therefore, it is recommended that they should sit or stand a few feet apart when in the same room for greater than ten minutes. At this distance the amount of radiation is negligible. Children should not sit for long periods of time on your lap during the first two months after the implant procedure.
Keep in mind objects that you touch or items that you use do not become radioactive. Bodily waste, such as urine and stool are not radioactive.
Notify your doctor if any of the following occur:
• You are unable to urinate and feel bladder fullness
• You pass blood clots in your urine
• You pass a seed
• You have a fever greater than 101 degrees