What to expect after your Prostate Seed Implant
There are things you should know after you have a Prostate Seed Implant. This handout will explain these things. Also see HFFY # 6567, Radiation Safety with Prostate Seed Implantation.
24-48 hours after your implant
Avoid heavy lifting or a tiring activity. You may also want to keep using cold packs on the area under your scrotum. You can use these cold packs 2-3 times a day for 20-30 minutes. You may also use Tylenol for discomfort if you need to.
Below are listed some common side effects that may occur in the first weeks after your implant…
Bleeding
Some patients have some bleeding in the area behind the scrotum. This bleeding can occur under the skin. It can lead to bruising and/or swelling in the region of the scrotum, penis, and groin. These effects will resolve with time. Do not take blood thinners for 3-4 days after the implant. The doctor or nurse will go over this with you.
It is also common to see blood in the urine after the implant. Your urine may be pink-tinged to light red. You may also pass small clots of blood. Drink at least 2-3 quarts of liquid per day for 4-5 days after the implant. This will help to reduce the number of blood clots that form in the bladder. If you pass large amounts of pure blood or large blood clots (more than 1 cup over a 24 hour period), call the radiation doctor.
Problems with Urinating
Some patients have problems urinating after an implant. You may feel like you have to go all the time or right away. Your prostate gland will swell after your implant. Sometimes it swells so much you are not able to urinate. This can happen while you are still in the hospital. If so, you will be sent home with a bladder catheter to drain urine out of your bladder. We will give you instructions if you are sent home with a bladder catheter.
Some patients are able to pass urine while in the hospital. After they get home, however, things may change. They find they cannot urinate. This can happen in the first 24-48 hours after discharge. If you are unable to pass urine, call the radiation doctor. He or she will tell you what to do. You may be told to continue to drink fluids and wait. You may be told to go to the nearest Emergency Department. If you go to a non-UW facility, take this paperwork with you.
Problems with Bowel Movements
You may have loose bowel movements after the implant. This may last from a few days to a few weeks. It occurs because the seeds put into the prostate gland are close to the rectum. The rectal tissues can become inflamed. Call the nurse if this happens. He or she may tell you to cut back on your fiber intake and/or spicy foods. If still a problem, you may be told to take some Immodium™. Let us know if you have bowel problems that last more than 1-2 days.
Problems with Soreness
Some patients have soreness after the implant. This can be due to swelling. It is okay to take Tylenol, call if you do not get relief. It is also okay to sit on a donut-type pillow. You should keep moving around, eating, and drinking fluids. If your soreness is mild, it should go away in a few days. If the soreness and/or swelling are more than mild it can take a few weeks to go away.
Issues related to Sexual Function
For the first 2 weeks after your implant, you should not ejaculate. This helps to ensure that you do not expel any seeds. After 2 weeks, you may ejaculate, but you must wear a condom. Condoms should be used for the first 3 months after your implant. This will ensure that seeds do not go into your partner. If you notice a seed in the condom, do not touch it. Use a scissors to cut the condom. Flush the seed down the toilet. Please see HFFY # 6567, Radiation Safety with Prostate Seed Implantation. Your ejaculate may be dark brown to black. This is caused by inner bleeding. You may also have less volume. Over time, your ejaculate will return to its normal color.
In the months to years after your procedure
Some side effects from Prostate Seed Implantation may not appear for months to years. This can be related to the effects of the radiation on normal tissues. It can also be related to normal aging. These effects are listed below.
Chronic Problems with Urinating
Some men develop long term problems with urination. These problems can include passing urine often, the need to go right away, or having a decreased stream. The problems can also include urineincontinence or pain with the passing of urine. Men with these types of problems before implant are more likely to have these types of problems after implant. Keep drinking plenty of fluids. Avoid drinks with caffeine—it may help to reduce symptoms of having to go right away. If your symptoms cause problems, talk to your doctors and nurses. The doctors may be able to prescribe a medicine that may help.
Chronic Problems with Sexual Functioning
Long-term problems with sexual functioning can develop. These problems can have many causes. Some of these problems include not being able to have an erection, not having firm erections, and/or not being able to reach orgasm. Men who have these types of problems before an implant are more likely to have the problems after an implant. If sexual activity is a problem for you talk to your doctors and nurses. The doctors may be able to prescribe a medicine that may help.
Chronic Problems with Rectal Bleeding
It is rare but some patients can develop problems with rectal bleeding many months after the implant. Sometimes rectal bleeding is caused by passing hard, dry stools. The small blood vessels in your rectum can be damaged by radiation. Damaged blood vessels bleed more easily. Do not get too concerned if you see a small amount of blood on your stool or toilet paper. A stool softener may be helpful. You can also increase your fluid intake and/or add fiber to your diet. If you have large amounts of rectal bleeding, call your doctor.
Follow-up Care
Your radiation doctor will see you in the clinic after your implant. These appointments will be scheduled at regular intervals. The doctor will sometimes ask you to get lab work before your visit. The lab work can be done by your local doctor. This will help the doctor to see how well your implant is controlling your disease. When you visit, the doctor will ask you about your urinary, bowel, and sexual functioning. You will also be asked about any other health issues that have developed since your last visit.
Please call if you have any questions or concerns. The phone number for the Radiation Oncology Clinicis (608) 263-8500. If you live outside of the Madisonarea, 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.
Reference:
Miller, D. C., Sanda, M. G., Dunn, R. L., Montie, J. E., Pimentel, H. Sandler, H. M. & Wei, J. T. (2005). Long term outcomes among localized prostate cancer survivors: Health-related quality of life changes after radical prostatectomy, external radiation, and brachytherapy. Journal of Clinical Oncology, 23(12), 2772-2780.
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: 01/18/2013
Copyright © 01/18/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6566
Print Health Fact For You