ProstRcision side effects are less common than other prostate cancer treatment options. However, there are side effects that can occur, and it’s important to be aware of those as you move throughout your treatment process.
The most common ProstRcision side effect is a weak urinary stream with more frequent urination and increased urgency. These symptoms vary from man to man but are primarily related to the size of a man’s prostate and the number of urinary symptoms prior to the seed implant. Men who have a weak stream after ProstRcision typically find their symptoms gradually resolve over 6-12 months as the prostate shrinks and the normal and cancerous prostate cells disintegrate.
The cause of the weak stream is trauma to the prostate due to the insertion of the 8-inch long needles used to inject seeds into the prostate. Insertion of these needles causes sudden prostate swelling, which leads to compression (squeezing) of the urethra tube that empties the bladder and runs through the middle of the prostate.
Fortunately, there are treatment options available to correct slow urine stream following ProstRcision. Men who have a significantly slow stream are offered a medication called alpha-blockers such as Flomax® (tamsulosin), Uroxatral®, Cardura® or Hytrin®. This medication relaxes muscles inside the prostate irritated by the sudden swelling and, in turn, relieves pressure on the urethra, which results in better urination in most men.
The most common ProstRcision side effect we see associated with the rectum is more frequent bowel movements per day. For example, people may see an increase from one to two bowel movements per day. This can last for one to two months and then resolve. These bowel symptoms are due to irradiating around the prostate for microscopic capsule penetration. If a man has hemorrhoids, he may see spotting of blood, especially after a hard bowel movement. Stool softeners usually resolve this problem.
Another possible ProstRcision side effect is a urinary blockage. Overall, 2.6% of men will have enough swelling after the implant that they have blockage of the urethra and require insertion of a urinary catheter. The average time to wear a urinary catheter in men who have urethral blockage is six days.
We monitor for it but rarely see incontinence as a ProstRcision side effect. This is because the urinary muscles are not cut as part of the treatment. However, men who have had a prior TURP (roto-rooter operation) or have severe urinary urgency before the seed implant of ProstRcision may develop incontinence. Urinary symptoms are monitored during and after treatment completion.
The worst complication is a rectal fistula. A fistula means the development of a hole between the rectum and the urethra so that urine passes through the rectum. This is a serious condition that requires a colostomy bag and surgical repair. A fistula is rare after ProstRcision. Of the last 10,000 men treated, only one has had a fistula.
There are two main factors that determine the preservation of sexual function after ProstRcision: a man’s age and the quality of penile erection before treatment. For example, men with normal erection and age 50 or younger have a 94% chance of retaining sexual function, as compared to men aged 76 or older with normal erection function, who have a 40% chance of keeping sexual function. If men do have problems with erection, they may be prescribed a drug like Viagra® or Cialis®.
It’s not uncommon for people to be misinformed about the possible ProstRcision side effects, so we would like to go over some of those with you. First, you are not a risk to other people after you receive your treatment. You can be around anyone and can sleep in the same bed with your partner. However, to be on the safe side, we recommend that you keep two feet distance from young children and pregnant ladies (except for a brief daily hug) for two months after the implant.
Another ProstRcision side effect that people worry about is whether or not the treatment puts you at higher risk of developing another type of cancer. The short answer is no. The chance of men who have received ProstRcision developing other cancers is no different than what we see in the general population of men who have never been treated for prostate cancer.
ProstRcision causes limited negative effects on most men. The day after the implant, men can travel, work, go to the gym or play golf. Except for Tylenol, pain medication is rarely needed. Urinary leakage rarely occurs, and most men who are sexually active retain sexual function. Some men report a mild degree of fatigue for a few months after treatment. On a long-term basis, a few men will develop a temporary increase in urinary symptoms consisting of burning with urination and urinary urgency 18 months after the implant. These symptoms usually resolve within a short time. ProstRcision side effects are uncommonly seen after 24 months.