Department of Urology

Brachytherapy planning

Summary: This involves insertion of an ultrasound probe into the rectum to assess the suitability of the prostate for brachytherapy treatment

Contents:

What does the procedure involve?

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.

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What are the alternatives to this procedure?

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

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What should I expect before the 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.

Please be sure to inform your Urologist in advance of your surgery if you have any of the following:

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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.

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What happens immediately after the procedure?

The average hospital stay is less than 1 day.

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What should I expect when I get home?

You may experience slight discomfort and passage of blood in the urine due to placement of the catheter.

When you leave hospital, you will be given a “draft” discharge summary of your admission. This holds important information about your inpatient stay and your operation. If, in the first few weeks after your discharge, you need to call your GP for any reason or to attend another hospital, please take this summary with you to allow the doctors to see details of your treatment. This is particularly important if you need to consult another doctor within a few days of your discharge.

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What else should I look out for?

If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your GP immediately.

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Are there any other important points?

For specific advice relating to seed implantation, please contact the Brachytherapy Co-ordinator (Jo Treeby) on 01223 596330 or bleep 152-582 via the Hospital Main Switchboard (01223 245151).

Driving
It is your responsibility to ensure that you are fit to drive following your surgery. You do not normally need to notify the DVLA unless you have a medical condition that will last for longer than 3 months after your surgery and may affect your ability to drive. You should, however, check with your insurance company before returning to driving. Your doctors will be happy to provide you with advice on request.

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Is there any research being carried out in this field?

There is no specific research in this area at the moment but all operative procedures performed in the department are subject to rigorous audit at a monthly Audit & Clinical Governance meeting.

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Who can I contact for more help or information?

Oncology Nurses

Non-Oncology Nurses

Patient Advice & Liaison Centre (PALS)

Chaplaincy and Multi-Faith Community

MINICOM System ("type" system for the hard of hearing)

Access Office (travel, parking & security information)

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Can I obtain a printed version of this information?

Yes. You can print this Infosheet by using the print option on your browser or by clicking the "Print Infosheet" button at the top of this page.

If you wish to obtain the formal, printed version from Addenbrooke's or Hinchingbrooke, please contact your Consultant or Specialist Nurse.

To obtain this information in other languages, large print or audio format, e-mail Patient Information at Addenbrooke’s or telephone +44(0)1223 216032.

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common Side-effects (greater than 1 in 10)

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occasional Side-effects (between 1 in 10 and 1 in 50)

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rare Side-effects (less than 1 in 50)

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Hospital-acquired infection (overall risk for Addenbrooke’s Urology)

(These rates may be greater in high-risk patients e.g. with long-term drainage tubes, after removal of the bladder for cancer, after previous infections, after prolonged hospitalisation or after multiple admissions)

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