How is the Prostate Brachytherapy Procedure Performed?

1. Preliminary Diagnosis and Planning

Oncologist-urologist examination: The doctor collects an anamnesis, evaluates general health and previous test results. A digital rectal examination is performed if necessary.

Instrumental studies: PSA blood test, TRUS (transrectal ultrasound), MRI, or CT to clarify the size, shape, and localization of the tumor.

Dosimetry planning: Based on ultrasound, CT, or MRI data, a 3D model of the prostate is created. Specialists (radiologist, oncologist, medical physicist) calculate the number of catheters and the placement of the radioactive source.

2. Preparation for the Procedure

Anesthesiologist consultation: The optimal type of anesthesia is determined (general, spinal, or epidural). Age, weight, and comorbidities are taken into account.

Pre-intervention recommendations: Dietary restrictions (usually 6–8 hours before anesthesia). Sometimes a cleansing enema is prescribed for better visualization.

Stabilization: Control of chronic diseases (cardiovascular, diabetes) is ensured to reduce risks during manipulations.

3. Catheter Implantation and Radiation Session

Patient positioning: The patient is placed in a lithotomy position. Access is controlled via ultrasound.

Insertion of catheters: Under visual control, several thin hollow tubes (catheters) are inserted. Precise positioning is vital for even radiation distribution.

Connection to Bebig Multisource: A radioactive source (Iridium-192) is sequentially fed into each catheter for a calculated time.

4. Completion and Rehabilitation

Inpatient observation: Hospitalization usually lasts from a few hours to a day. Minor discomfort in the perineum may occur.

Recovery recommendations: Avoid heavy physical activity for 1–2 weeks, drink plenty of fluids.