urologist's office will schedule your procedure with
the University Prostate Brachytherapy coordinator.
All pre-registration and insurance information
is provided at that time. However, you may
receive a call from University Hospital's financial
counselors to verify the information is correct.
The Coordinator will contact you to introduce herself
and her role in your care at the Brachytherapy Center.
She will provide you with a brief
overview of the surgical treatment plan as
well as the process from Pre- Admission to discharge.
You will be given a contact number for the University
Brachytherapy Program including a 24-hour pager, and
directions to the facility.
An appointment for pre-admission testing is also
made at this time. Your physician orders preoperative
tests to ensure your safety during the procedure and
your pre-admission testing must be completed one week
prior to your day of surgery. These tests include
blood work, an EKG, and CXR. A note from your primary
medical doctor may be required depending on your medical
Pre-admission testing is offered at University Hospital;
please allow approximately 1/1/2 hours for this process.
In order to process your information, you must bring
any insurance cards and forms you have. You are responsible
for meeting the requirements of your particular insurance
plan, including any necessary preauthorizations and/or
referrals prior to your procedure.
The Pre-Admission Testing Center is located on the
Lower Level (LL) of the Doctors Office Center (DOC)
in Room 0400. The telephone number is (973) 972-2929
and the fax number is (973) 972-2942. Parking is available
in the DOC parking deck, directly adjacent to the
Doctors Office Center.
When you come for Pre-Admission Testing, the Nursing
Coordinator will also meet with you to discuss the
procedure and answer any questions or concerns you
may have. Based upon your specific needs and health
history, an individualized plan of care will be designed
for you. Your discharge instructions will be explained
to you at this time (and will be reviewed again at
your actual discharge).
It is important for you to keep your physician informed
of your physical condition prior to and including
the day of your procedure. Remember to let your physician
know if you are taking any medications; if you have
any allergies: or if you now have or have had a history
If your physical condition changes, (for example,
you develop a cold, cough, fever, or flu), or if you
need to cancel your procedure, please contact your Urologist and the Prostate Brachytherapy Coordinator immediately.
For your comfort and safety, follow these instructions
the day before your procedure:
Be sure to follow these important instructions on
the day of your procedure:
The University Prostate Brachytherapy
Program is located in the Same Day Surgery Unit at
the Doctors Office Center, lower level. When you arrive, a nurse will take your vital
signs, discuss any questions or concerns you may have,
and review your medical history. The anesthesiologist
will also meet with you in the pre-op area and discuss
your anesthesia plan. An intravenous line will be
started for the delivery of anesthetic medications.
Your escort will be able to stay with you in the
pre-operative holding area until you are taken into the operating
room. This person will then be asked to wait in the
family waiting room until your return.
During the hour-long procedure you will be placed
on the operating room table in a comfortable position.
Your urologist will be present as well as the Prostate
Brachytherapy Team which includes the Radiation Oncologist,
Physicist, Anesthesiologist and Nursing Staff.
The Anesthesiologist will apply electrodes
for cardiac monitoring, a blood pressure cuff, and
a pulse oximeter to measure oxygen saturation. You
will be monitored throughout the entire procedure.
General anesthesia will be used, and you may also
receive medication to help you relax prior to the
Once you are asleep, your urethra and perineum will
be covered with a drape and washed with antiseptic
soap. An ultrasound probe is placed in the rectum
so that a picture of your prostate appears on a video
screen. A number of seeds--the quantity is determined
by the size of your prostate gland--are inserted through
special needles that deliver the seeds to the prostate.
The ultrasound probe insures the needles are guided
accurately. Once the seeds are implanted the needles
After the seeds are implanted, your urologist may
opt to do a cystoscopy. By inserting a cystoscope
into your urethra, the urologist is able to directly
examine the bladder. Also, at this time a foley catheter
will be placed in your bladder; this will allow the
nursing staff to monitor your urine for any seeds
that may be passed.
Ordinarily, the procedure takes about one hour. After
the procedure is complete, the Brachytherapy team will transport you to
the recovery room.
You will rest in the recovery room for approximately
45 minutes and will be monitored throughout your stay.
You will receive light nourishments and any medication
prescribed by your physicians.
You will then be transported one floor up from the
Same Day Surgery Center to our convenient Imaging
Center, where a post-implant CT scan will be taken
to verify the seed placement.
Once the CT scan has been read, your catheter
will be removed. Typically, you will be required to urinate
prior to your discharge.
Your urologist may prescribe an antibiotic,
but usually no prescription pain medication is required.
Your total stay at the University Prostate
Brachytherapy Center is approximately four hours.
It is possible to pass a seed with your urine. You
will be given a strainer to take home so that you
may strain your urine for one week and look for seeds
(silver in color and the size of a grain of rice).
If you find a seed, pick it up with a tweezer and
place it in the lead container given to you at the
time of discharge. Only
return the lead container if you find one or more
The procedure causes minimal trauma to the region
beneath the scrotum, but there can be some tenderness,
bruising or swelling. Some patients may want over-the-counter
pain medication for a few days after the implant.
Patients may be tired and want to rest, but some feel
up to normal activities quickly. Of course, as in
all medical procedures, patient response is varied.
The soreness and swelling usually go away in a few
days. Some men may experience blood in their urine
and semen, and a small percentage may experience rectal
irritation or bleeding. Some men may experience discomfort
while urinating or the need to urinate more frequently.
These symptoms usually begin one to two weeks after
implantation and gradually decrease over time as the
seeds lose their strength. If the burning sensation
persists, contact your doctor and your doctor may
prescribe medication. For some men, nighttime urination
will be more difficult than daytime because there
may be a slightly greater swelling of the prostate
at night. Often, this symptom can be diminished by
simply walking for a brief period of time.
If there is any sexual intercourse during the first
two weeks following the implant, you must
use a condom. It is normal for semen to
be discolored (dark brown to black) due to bleeding
that occurred during the procedure. After two months,
condom use should return to normal public health recommendations.
The seeds that
have been implanted in your prostate emit low level
radiation for a very short period of time. The radiation effect is mostly confined to the prostate itself and
should not affect your other organs or people near
you. Objects you touch do not become radioactive
nor are your stool or urine radioactive.
Although the radiation poses no risk to people around
you, we advise you to be more cautious around pregnant
women and children. Children and pregnant women should avoid prolonged
close contact with you for one month with palladium
seeds, and two months with iodine seeds: six feet
is a safe distance.
Children should not sit on your lap for one-two
months after the procedure.