Brachytherapy planning for prostate cancer

What is this?

This involves insertion of an ultrasound probe into the rectum to assess the suitability of the prostate for brachytherapy treatment this procedure may involve telescopic examination of the bladder and is not a form of treatment

What alternatives are there?

Watchful waiting, external beam radiotherapy, radical prostatectomy, laparoscopic prostatectomy, robotic prostatectomy, hormone therapy

What to expect before procedure

The day before your admission, you will be asked to take a laxative to clear the bowel. You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural anaesthetic which improves or minimises pain post-operatively. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. The procedure takes approximately 30 minutes. A catheter is passed in the bladder via the urethra (water pipe) and removed at the end of the procedure. An ultrasound probe is then inserted into the rectum and the prostate measured to plan subsequent treatment. Occasionally, it is necessary to direct 2-4 needles into the prostate through the skin between the scrotum and the anus (the perineum). These needles are simply markers to ensure that the radioactive seeds can be inserted into all areas of the prostate when you attend for seed implantation.

After the procedure

The average hospital stay is less than 1 day.

Potential side effects

Common;

Occasional;

Rare;