Recovery:

After the procedure you will be taken to the recovery unit where regular observations (your blood pressure and pulse) will be taken by a nurse until you have recovered from the anaesthetic and fully woken up. You will have a drip in your arm and also a tube (catheter) in your bladder to drain your urine. You will also be lying on your side with the brachytherapy needles protruding from your perineum.

Ward nursing:

As you have brachytherapy needles protruding from the skin of your perineum, you will require specific nursing whilst in hospital. This will require special care of your bowels and regular changes of position. You can not mobilise whilst the brachytherapy needles are in place and you must lie on your back or side. Special care is required to prevent pressure sores from forming.

Catheter:

After the procedure, you will have a catheter in your bladder which will be removed on the morning when you are discharged. It is not uncommon to have bloodstained urine following the brachytherapy treatment.

Bowels:

Whilst in hospital during the treatment with the rods in place, it is desirable not to move your bowels and it is for this reason you are placed on a low residue diet and have a Fleet oral enema prior to the procedure. If you do need to move your bowels whilst in hospital let the nursing staff know and they will assist you.

After leaving hospital, some patients suffer from constipation. All that is usually required is an increase in fibre by eating fresh fruit and vegetables, however occasionally a stool softener may be required. Occasionally patients complain of bowel irritation such as diarrhoea or frequency however this rarely requires specific medical treatment and can usually be dealt with by reducing the roughage in the diet by minimising fruit and fibre intake.

Bruising:

Bruising of the area behind your scrotum is quite common, and you may also notice blood loss from the rod entry points. This may last about 3–4 weeks and will resolve. Applying an ice pack can help decrease discomfort, but this requires no treatment.

Medications:

Whilst you are in hospital you will be given antibiotics to prevent infection, medications to prevent clots forming in your legs and pain relief. After the procedure when you are discharged home, you will be given the following medications

Flomaxtra or Xatral:

These medications are known as alpha blockers and relax the smooth muscle surrounding the prostate and bladder neck. They make it much easier to pass urine and can counteract the difficulty in passing urine that some men have after brachytherapy, due to swelling of the prostate from the procedure.

Whilst you are in hospital, either of these medications will be prescribed for you at your preoperative consultation with Dr Swindle. You will be asked to commence this 3 days prior to the brachytherapy and will continue it for approximately 8 weeks after the brachytherapy. You take one tablet a day - at night before you go to bed.

It can have potential side effects, the most common of which is dizziness. If this occurs, cease the medication and contact Dr Swindle. After 8 weeks, you should stop taking the medication each day and take it every second day for 2 weeks. If you have no problems with passing your urine at the end of the 2 weeks then cease the medication. If you have trouble passing your urine when you are taking the tablet every second day, increase it back to one tablet a day and contact Dr Swindle.

Noroxin:

This is an antibiotic and is started in hospital on the evening of the procedure and continued for 3 days after the procedure. It is taken twice a day either 1 hour before or 2 hours after food. Allergic reactions to medications sometimes occur and can cause a rash or unusual reaction. If this occurs stop taking the antibiotic and call Dr Swindle for advice.

Pain Relief:

The procedure does not cause a great deal of pain and usually all that is required is panadol. Occasionally stronger pain relief such as Panadeine may be required.

Sexual Activity:

It is recommended that sexual intercourse can be resumed 1 month after the brachytherapy. It is common for the semen to be discoloured dark brown or black as a result of bleeding into the prostate or the seminal vesicles as a result of the implant. This discoloration should resolve within a few months. If you are taking hormone therapy, you may not desire sexual activity or may not be capable of an erection.

Urination:

Urinary frequency and burning are common after high dose rate brachytherapy. These symptoms may continue for several weeks to a few months after the procedure and are most troublesome from 1-3 months after the implant. Nearly all patients have these symptoms and they resolve in 90% of patients. 10% of patients can have ongoing symptoms for up to a year and 1% of men can have permanent symptoms.

These symptoms can be helped by an alpha blocker such as Flomaxtra or Xatral and occasionally an anti inflammatory medication may be prescribed. Very rarely if patients have terrible symptoms a catheter may be required but this is extremely uncommon. It is not uncommon to have some blood in your urine after the procedure lasting up to a few weeks. If it lasts longer than this let Dr Swindle know.