Radioactive Seed Implant
Admitting Examination and Labs
The prostate brachytherapy procedure may be performed in the office or in a hospital, depending upon a patient’s specific situation. The office setting has become our preferred brachytherapy venue unless there is a specific reason why this is not possible. If the brachytherapy procedure is performed in the office, the brachytherapy related prescriptions and nursing instructions are given to the patient at the time of his ultrasound volume study. Routine preoperative blood tests and an EKG are also ordered. If you have other medical problems, a preoperative clearance by your regular doctor may also be required.
The procedure could also be done at one of several hospital facilities within the San Diego region if necessary. Different hospitals have different admitting requirements. Typically, they require an additional office visit for a preoperative physical exam plus or minus admitting blood tests, usually about a week before the procedure. During this “admitting examination” appointment, the brachytherapy related prescription medications are given to the patient. Additionally, there is a pre-anesthesia evaluation by the anesthesiologist, and they handle the scheduling and conduct of this aspect with the patient directly.
Whether the procedure is done in the office or the hospital, the prescriptions are to be filled before the brachytherapy procedure. The exact medical regimen may change from time to time, but as of June 2003, has typically included the following:
Cipro - (Antibiotic) 500mg # 10 – one pill twice per day, starting the day before the procedure, and finishing 5 days later – To prevent infection – If the patient is allergic to this medicine, another antibiotic may be substituted.
Decadron - (Steroid anti-inflammatory) 4 mg (3 pills) Take all 3 at bedtime the night before the procedure – To reduce prostate swelling
Flomax – (Alpha-blocker – medicine that relaxes the bladder and allows a better urinary stream) 0.4 mg # 60 with 10 refills – This is the only long-lasting medicine. The prostate swelling and inflammation process usually takes 3-12 months to fully resolve, and our patients usually find this type of medication to be helpful to allow better urine flow during this time.
Medrol Dose-Pak (Steroid anti-inflammatory) – 21 pills in a card – Punch these out and take as directed as soon as you have been discharged from the hospital – To reduce prostate swelling after the procedure
Vicodin (Pain-killer) # 20 with one refill – For post-procedure pain – Most patients do not have very much pain after the procedure but there are occasional exceptions and usually Vicodin works well for them – Do not drive while taking this medication.
Sometimes substitutions or alterations may be made, particularly in the case of Flomax, where insurance plans often substitute other alpha-blocker medicines on their drug formulary.
