How to prepare for your Prostate Seed Implant (PSI)
A person having a PSI takes part in a 3-phase process. The first phase of the process is called the PSI Work-Up. This phase makes sure that a PSI is right for you. If a PSI is right for you, you begin the second phase of the process. The second phase of the process lasts 1 to 3 weeks and is explained in this handout. This handout will tell you how to prepare for the day of your implant.
Preparing for your PSI requires that you complete 4 tasks. First, you will need to arrange for your transportation home after your implant. Second, you may need to make changes to the medicines you take on a daily basis. Third, you will need to complete a bowel prep. This bowel prep begins the day before your implant. Fourth, you will need to get to the hospital at the right time. These tasks are explained more fully below.
Task 1: Arrange Transportation Home after your PSI
You will need to arrange for a friend or family member to drive you home after your implant. This is because patients getting anesthesia are not allowed to drive home. This is for the safety of yourself and others.
Task 2: Make changes to the medicines you take on a daily basis.
You will need to make some changes to the medicines that you take on a daily basis. These changes are made both before and after the implant.
Before your implant:
If you take blood thinning medicines, you will need to stop taking them. You should stop taking them 5-6 days before the implant. You can resume taking these medicines 3-4 daysafter the implant. The nurse will give you more specific instructions about this.
You will need to start taking a medicine called tamsulosin hydrochloride. You will start taking it several days before the implant. The doctor will give you a prescription. This medicine will help you to pass urine after your implant. It works by relaxing the muscles in the neck of your bladder. You should take at bedtime. It can lower your blood pressure. It can also react with other blood pressure medicine. You should get up slowly when first taking this medicine as it can cause dizziness if you get up too quickly. The RN will talk to you about this. Let us know if you experience dizziness by taking the dose prescribed by your doctor. He or she may wish to lower the dose.
After your Implant:
You will be given a prescription for an antibiotic. It will help to prevent an infection. Call the radiation doctor if you develop a rash or any other problem with this medicine.
Continue to take tamsulosin every evening at bedtime. Take it until you see the radiation doctor at your first follow up appointment. It will help you to pass urine. You may take Tylenol for discomfort. You may take 1-2 tablets (325mg) every 6 hours. Take these tablets with food or milk if you tend to get a stomach upset.
If passing urine is painful, you may take Pyridium® (phenazopyridine hydrochloride). The doctor will give you a prescription for this medicine. Take one tablet (200mg) three times a day. This medicine helps to lessen the pain that can occur with the passage of urine. It turns all body fluids orange.
If you take blood thinning medicines, you can resume taking them 3-4 days after the implant. Ask the nurse about this if you have any questions.
Task 3: Complete your Bowel Prep
You will need to prepare for your implant by completing a bowel prep. Your rectum needs to be clear of stool on the day of the implant. The bowel prep begins on the day before your implant.
Your implant is scheduled for ______________________________________.
You may follow your normal diet until 12 noon on _____________________.
At 12 noon on ________________________you must begin a clear liquid diet. You must stop eating all solid foods and dairy products. You must stop drinking any liquids that contain pulp or fiber.
Clear liquids include the following:
- Clear broth
- Consommé
- Tea
- Coffee, decaffeinated coffee
- Jell-O
- Carbonated beverages
- Hard candy
- Clear fruit juices (cranberry, grape, apple, cherry)
- Popsicles
- Fruitades or ices made from the allowed juices
You may eat and drink as much of the above as you would like.
DO NOT EAT ANYTHING AFTER MIDNIGHT on _________________________.
On the evening before your implant, you must give yourself a enema. This is an over-the-counter product. It can be bought at any pharmacy. The next morning give yourself another enema.
If you have been told to take your morning medicines, you should take them with only a sip or two of water.
Task 4: Get to the Hospital at the Right Time
Your Prostate Seed Implant has been scheduled for the following date and time:
_____________________________________________________.
You should plan to arrive at least one hour before the start time of your implant. .Allow extra time for traffic, parking, and getting checked in. Once you get to the hospital you will need to follow the steps listed below.
- Park in the parking ramp.
- Come in through the Hospital or Clinic entrance.
- Get your parking stub stamped in the “Town Square” area.
- Stop and check in at one of the Registration Desks.
- Go to the pre-procedure area: ________________________________________
In the pre-procedure area, you will be assigned to a room. In this room you will change into a hospital gown. A name band will be put on your wrist. The nurse will check you in. After this is done, a hospital escort person will bring you down to the procedure area on a cart. The implant is done in the radiation department.
Before starting the implant, the anesthesia doctor will talk with you. He or she will review your records and ask you questions. An intravenous (IV) line will be put into your hand or arm. You will be asked to walk into the procedure area and to lie down on the procedure table. A blood pressure cuff will be put on your arm. Sticky patches will be put on your skin to monitor your heart rate. Compression stockings will be put on to keep the blood in your legs moving.
The anesthesia doctor will give you medicines through the IV. These medicines will make you feel relaxed and sleepy. Once you are fully asleep, a breathing tube will be put into your throat. Your legs will be placed in stirrups. Your scrotum will be moved up out of the way.
The radiation doctor will clean the skin between your scrotum and anus with a germ-killing liquid. He or she will then insert a probe into your rectum. This probe will help the doctor to “see” your prostate gland. Hollow, stainless steel needles will be put into the tissue between your scrotum and anus. The ends of these needles will go into the prostate gland. Prostate seeds will then be threaded up through the needles and put into place. Placing all the seeds takes between 60-90 minutes. The number of seeds used depends on the size of your prostate gland.
After the seeds are all placed, your skin will be cleaned once more. Your legs will be taken down from the stirrups and put back down on the table. The anesthesia doctors will wake you up. You will be moved to a cart. A cold pack will be put on the skin between your scrotum and anus. You will be taken to the Post Anesthesia Care Unit (PACU). In the PACU your blood pressure and heart rate will be monitored. When you are more awake, you will be returned to the pre-procedure area.
After the PSI procedure
You will be given something to eat and drink. Your family will be allowed to visit. You will get an information card for your wallet. This card will show the date of your implant. It will also show that you have radioactive seeds in your body. When you are fully awake, have had something to eat and drink, and are able to easily urinate you will be ready for discharge.
Before you leave the hospital you will return to the Radiation Department. A post implant CT scan will be done. This scan will check the placement of the seeds. The doctor and nurse will give you final instructions about what to do at home. A friend or family member will drive you home.
At home you should take it easy for a few days. Please see HFFY # 6568, What to Expect after a Prostate Seed Implant.
Follow-up Appointment
You will see the radiation doctor about one month after your implant. The nurse will help you to set this up. Your bowel and bladder function will be asked about. You will be asked about the medicines you are taking. This follow up appointment can be set up when your implant is scheduled.
Please call if you have any questions or concerns. The phone number for the Radiation Oncology Clinic is (608) 263-8500. If you live outside of the Madison area, call 1-800-323-8942. If the clinic is closed, your call will be transferred to our answering service. Ask to speak to the radiation doctor on call. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/28/2010
Copyright © 06/22/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5731
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