Side Effects of a Permanent Implant
Frequently Asked Questions about Permanent Radioactive
Seed Implants for Prostate Cancer
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Main FAQ Page
Prostate Cancer Issues
Logistics of a Permanent Implant
Side Effects of a Permanent Implant
Potency after a Permanent Implant
Radiation Safety after Permanent Implant
Pros and Cons of Implants
Follow-up after a Permanent Implant
Urinary Side effects after a Permanent Implant
What can the patient expect to feel like after the procedure?
Like all procedures, the response can vary. The procedure causes minimal
trauma to the region beneath the scrotum, but there can be some tenderness
and bruising. Patients require no medications for pain. Patients are not
limited in their activities after the procedure.
What side effects might occur days after the procedure and for how
long a period of time they continue?
As a result of the implant procedure, some men experience mild discomfort
in the groin area for two to three days. Some blood may be seen in the urine
and sperm for a few days after the procedure similiar to what was experienced
after the prostate biopsy. This is normal and stops after two to three days.
The scrotal and perineal area can also become swollen/bruised or black and
blue. The effects of the radiation from the seeds usually begin one to two
weeks after seed implantation. The main symptoms are urinary difficulties
such as frequency, urgency, weak stream or slight pain. These can last for
2-6 months. These can usually be effectively managed with simple medications.
What is the likelihood of blood in the urine and passing blood clots
after the procedure?
This is common during the first couple of days and resolves without requiring
intervention. Occasionally it lasts longer or occurs spontaneously some
time after the implant. If you should have any questions or concerns contact
your physician.
Can seed implantation cause long or short-term incontinence?
The risk of long-term incontinence after either seed implant alone or
in combination with external beam radiation in the typical, (non-TURP),
patient is extremely rare, less than 1%. Over the short term, some patients
experience significant urgency and may have difficulty reaching the restroom
without some slight dribbling. This resolves over one to two months.
If the patient had BPH (benign prostatic hypertrophy) prior to seeding,
will it go away or return later?
A good question that we don't know the answer to.
What effect would a TURP, (transurethral revection of prostate) either
previous to or after seed implantation have on treatment?
In patients with a large TURP defect, it is technically challenging
to perform a good implant. In our experience TURP patients who received
an implant at Thomas Jefferson University have not experienced an increased
risk of urinary incontinence. TURP after the implant also imparts a risk
of incontinence. Therefore, we try to avoid doing a TURP in implant patients.
When a TURP is necessary after implant, someone who understands the problems
associated with it should perform the procedure.
Please explain why nighttime is worse than the daytime for urine retention
and difficulties in urination?
For many men nighttime urination is a different experience than the daytime,
with often a slower stream or difficulty initiating a stream. The reason(s)
for this are unclear. There seems to be more urine made at night than during
the day. Alpha-blockers (Cardura, Flomax or Hytrin) are often prescribed
to help minimize this symptom. Generally this worsening of the urinary stream
at night goes away over a few months.
Do you recommend any strategies for alleviating nighttime urinary
problems?
Alpha-blockers can often help a lot. Other techniques to help flow are:
walking around, getting into a warm shower or bathtub and using anti-inflammatory
medications.
What are the chances the patient will be affected by prostatitis after
seeding?
Prostate brachytherapy delivers a high dose of radiation to the prostate
and periprostatic tissue. The major treatment related symptoms are urinary,
due to radiation prostatitis. Nearly all patients develop some degree of
dysuria, daytime urinary frequency and increased nocturia which typically
resolves as the seeds lose their energy, over a period of months.
Is there any chance of infection?
Yes, however, rare. We use intravenous antibiotics in the operating room.
None are or given when you leave the hospital. There have been no urinary
infections in our patients who have received an implant.
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