Patient preparation directions for your high dose rate brachytherapy are very important and need to be followed or it is possible that your implant procedure may have to be cancelled.

Diet:

You will need to commence on a low residue diet 3 days prior to the procedure. The purpose of a low residue diet is to minimise the volume of your stools and help reduce the contents of your bowels. The details of a low residue diet will be provided to you by Dr Swindle’s staff. 24 hours prior to the procedure, commence on a clear liquid diet and eat nothing solid for this 24 hour period. This is extremely important.

Enema:

You will be admitted to hospital the evening prior to the procedure and will be given a Fleet oral enema, which should be taken with a litre of water. Do not have anything to eat or drink from 12 midnight prior to the procedure. The nurses in the ward will give you 2 Microlax enemas at 5am on the morning of the procedure. They usually work within 30 minutes.

Medications:

Many medications can thin the blood and cause excessive bleeding during surgical procedures. It is very important that you cease any blood thinning medications 7-10 days prior to the procedure. Common medications that thin the blood are Aspirin, Warfarin, Plavix (Clopidogrel) and anti-inflammatory pain medications.

For a complete list of medications that may thin the blood or interfere with a surgical procedure, please refer to our information on surgery preparation and medications. Do not stop any of these medications without discussion with Dr Swindle as he will advise you of the exact timing to cease any medication.

Please ensure Dr Swindle is aware of all drugs, pills and medications that you take, whether on prescription or not, even if they are not on the list of medications to avoid.

Admission to hospital:

You will be admitted to hospital at approximately 4pm on the afternoon prior to the procedure. It is recommended you bring loose-fitting and comfortable clothing such as pyjamas for after surgery. If you wear contact lenses, glasses or dentures, bring a case so these can be stored during surgery.

Generally unless there are significant problems, you will see the anaesthetist on the morning of surgery. Once you are due to go to theatre, the nurses will complete a checklist and escort you to the theatre. You will enter the theatre anaesthetic room where you will be once again check-listed by the theatre staff and anaesthetist.

A drip will be placed in your arm to allow the theatre staff intravenous access during the operation. Patients usually undergo a spinal anaesthetic, where a very thin needle is inserted into the back and you go numb from the waste down. You will be aware during the procedure but will not feel any pain.

On the morning of your procedure, you will be given a surgical gown to wear and anti-thrombus compression stockings will be fitted after you have showered. You will also be fitted with SCD’s or sequential compression devices after you have showered. These compress your legs using specially designed air bags and help prevent blood clots, know as deep vein thrombosis (DVT), forming in your legs.

Though the stockings and devices can come off to shower during your hospital stay, they must remain on at all other times to reduce the risk of blood clots forming in the legs. The stockings are removed when you are ready to be discharged from hospital.

Pre Operative Preparation:

You will see Dr Swindle the week or so prior to the operation, to ensure that all necessary investigations are up to date and have taken place and that all important pre operative consultations ;have occurred. The following things will be double checked: blood and urine test results (FBE, ELFT’S, MSU), x-ray results (CXR, CT scan and possibly bone scan and MRI of the prostate), flexible cystoscopy results and urine flow rate results.