ProstRcision is an outpatient procedure meaning that it does not require a hospital stay. Even with the delicate nature of implanting radioactive seeds into the prostate, the procedure itself doesn’t take very long – usually about 45 minutes. Most patients go home within hours. While this is the typical outcome, every patient is unique, and it is imperative to consult with your ProstRcision physician on your treatment.
Performed by a urologist and a radiation oncologist, the seed implant is an outpatient procedure that lasts approximately 45 minutes. Patients are given general anesthesia, and the man’s legs are placed in stirrups. Then an ultrasound probe, which is connected to a television monitor, is inserted into the rectum. To get the seeds in place, and while watching the monitor, long hollow needles are inserted through the perineum (the area between the testicles and the rectum) and into the prostate.
Next, a seed implant device is attached to a needle, and seeds are injected into the prostate. The process is repeated until all of the seeds have been injected. The number of seeds needed depends on the size and shape of the prostate, as well as the severity of the cancer.
The average number is 74 seeds, but we have implanted as few as 45 and as many as 230.
After all the seeds have been injected, the urologist performs a cystoscopic exam, which is the insertion of a tube through the urethra and into the prostate and bladder to check on these organs. Once the urologist sees that everything is okay, a urinary catheter is inserted, and the patient is sent to the recovery room, where he is awakened.
The patient returns to RCOG the following day to have the urinary catheter removed.
Since cancer cell leakage cannot be detected prior to completing any treatment, we use follow-up linear accelerator irradiation to make sure we target the entire area, guided by the implanted seeds. This follow-up treatment begins 21 days after the seed implant and is delivered slowly over a six to seven-week period. Treatment is similar to getting a pelvic X-ray each day and lasts approximately 10 minutes. Patients can resume normal daily activities immediately after each treatment.
When compared to other treatments available today for prostate cancer, ProstRcision patients experience minor, if any, side effects. One of the great advantages of ProstRcision is that important muscles and sex nerves are not cut, so men stand an excellent chance of maintaining bladder control and sexual function. Additionally, since ProstRcision is a relatively fast outpatient procedure, patients enjoy a high quality of life, and can go back to work or other regular activities, usually the day after implant. Other than Tylenol, most patients don’t usually need medication during the recovery time.
However, there are a few minor side effects that some patients experience following ProstRcision treatment. The most commonly reported side effects are a weak urine stream and more frequent urination, and more urgency. It’s important to note that these symptoms vary from patient to patient and are usually connected to the size of the patient’s prostate and the severity of his urination symptoms before treatment.
Patients who experience these symptoms usually see them decrease over the next 6-12 months as the prostate shrinks. Some patients also report a feeling of fatigue that may last for several months after treatment. It is unusual for patients to experience side effects more than 24 months after ProstRcision.
As with any procedure or treatment, there are some rare complications associated with ProstRcision.
It is reported that 2.6% of men who have ProstRcision experience a urinary blockage because of extensive swelling. This requires the insertion of a urinary catheter. On average, men with a urinary blockage must wear a urinary catheter for six days.
Rectal fistula is the most serious complication associated with ProstRcision. This condition is when a hole develops between the rectum and urethra, causing urine to pass through the rectum. Patients with rectal fistula require a colostomy bag and surgical repair. Rectal fistula after ProstRcision is rare. Out of 10,000 ProstRcision patients, only one has experienced rectal fistula.
While ProstRcision increases a man’s chance of maintaining sexual function compared to other procedures, it also depends on his age and his history of erectile dysfunction (ED) prior to ProstRcision. In men 50 years of age or younger, with no ED or mild ED, 95% maintain sexual function. For men 75 years of age or older, with no ED or mild ED, only 45% maintain their sexual function. We find that common medications used to treat ED usually help. A man’s chance of keeping his normal sexual function can be calculated using our computerized database.
Talk to a Prostate Cancer Nurse Patient Navigator who can answer your questions and/or help set up a consultation with a radiation oncologist.