How is the implant done?
Once under general anaesthesia you will be positioned for the implant, lying on your back with your legs up and knees flexed. An ultrasound probe is placed into the rectum to provide high precision images of the prostate, the ultrasound is operated by a Consultant Radiologist or a Urologist.
A series of ultrasound scans through the prostate are captured on a dedicated planning computer to create a 3D reconstruction of the gland. A Medical Physicist uses this data to produce a treatment plan in which seeds are positioned in the gland to maximize the radiation dose to the prostate (and cancer) and minimize the dose to critical nearby structures such as the urethra and rectum. The treatment plan includes the co-ordinates of each seed's position within the prostate gland.
Needles are inserted by the Oncologist or Urologist through the skin between the legs behind the scrotum (perineum) and into the gland, the seeds are implanted through these needles to the positions determined in the treatment plan. Each needle is guided to it's correct position using ultrasound imaging manipulated by the Radiologist or Urologist. Needle placement is continuously monitored using ultrasound and fluoroscopy and when correct positioning is confirmed the radioactive Iodine-125 seeds are released. The needles deliver between 2-6 seeds each and normally 20-30 needles are required.
The entire procedure takes 1 to1.5 hours and the process is interactive allowing the treatment plan to be adjusted as the implant progresses to optimise the final distribution of the seeds.
When you return to the ward, a urinary catheter will be in place and your perineum may be sore but pain relief will be provided.
