Brachytherapy with Anesthesia
A Patient Guide for Treatment of the Uterus, Cervix, or Vagina
Brachytherapy is a type of internal radiation
therapy. We will tell you what it is and how
to prepare for it. Please underline anything
you do not understand. Also, write down
any questions you have. When you come for
a visit bring this handout and your questions.
Your health care team will answer your
What is Brachytherapy?
This delivers a high dose of radiation to a
small area within the uterus, cervix, or
vagina. Small, hollow tubes are placed by
your doctor. A tiny, radioactive source,
attached to a wire, is inserted through the
tubes. The wire is left in place for a short
time, most often 5-20 minutes. The wire
then moves out of the tube and goes back
into its storage case. The doctor takes out
the tubes and the treatment is complete.
This is done in the Radiation Oncology
Department. Most patients have 5
treatments and are scheduled 1-2 times per
week. Each treatment takes 6-8 hours from
start to finish. This is a surgical procedure.
It is done under anesthesia. Anesthesia is
given by doctors and nurses. You will fall
deeply asleep and remain comfortable.
What do Brachytherapy instruments look
The drawing below shows some of the
commonly used instruments. It also shows
where they are placed in the body. They vary
in size and shape. Your doctor will choose
the ones that are right for you.
How do I get ready for Brachytherapy?
Getting ready for the first treatment requires
a number of tasks. These tasks are done in a
pre-procedure visit that takes 2-4 hours.
ξ You will have a complete medical
history and physical exam from the
ξ Your current medicines must be
reviewed. The review includes the
names, doses, and number of times
you take them per day.
ξ Some patients need lab work, an
ECG, or a chest x-ray.
ξ You may also visit the Pre-procedure
Assessment Safe Service (PASS)
Clinic. Here, your records are
reviewed to prepare for the
anesthesia. You will be asked about
any prior events with anesthesia.
ξ Please note, patients who get
anesthesia are not allowed to drive
for 24 hours. On the day of your
procedure, a friend or family
member will need to drive you
home. For your safety, someone
(age 16 or older) needs to stay with
you today and tonight. You should
not drive or make important
decisions until the next day.
ξ You will be called 2 days prior to
your procedure with your pre-op
instructions and time of arrival.
What happens on the day of the
Do not eat or drink anything after midnight.
If you do eat or drink something after
midnight, your treatment may be canceled.
This is for your safety. Follow medicine
instructions that you were given at your
pre-operative history and physical
Please plan ahead.
ξ First Day Surgery Unit, enter
through the hospital,
not clinic, door.
Follow the gray stone
path to the D elevator.
Take the D elevator to
the 3rd floor. Turn
left to the First Day
Surgery Unit door.
ξ Bring your parking stub with you.
In First Day Surgery, you will change into a
hospital gown. The nurses will take your
blood pressure, pulse and may check your
blood sugar level. They will insert a small
intravenous (IV) needle into a vein in your
hand or arm. This IV will be used for
medicines and fluids. Shortly before your
treatment is scheduled to begin, patient
escort will bring you down to the Radiation
Oncology department. You will be on a
cart. A member of the anesthesia team and
your radiation doctor will talk to you. You
may be asked to walk into the treatment
room. You will be asked to lie down on a
narrow treatment table. We will help you
with this if it is hard for you. The anesthesia
team will give you medicines to put you to
sleep. Once you are deeply asleep, the
radiation doctor will get you ready for the
The Brachytherapy Treatment
1. Loose cotton stockings will be put on
your legs to keep them warm.
Compression leggings that inflate and
deflate will also be put on your lower
legs. These are used to help blood
flow. During the treatment, you will
lie on your back. Your legs will be
put up into leg rests.
2. The radiation doctor will do a pelvic
exam. Your skin will be cleaned
with a special soap. A small tube
(Foley catheter) will be put into your
bladder to collect urine. This tube is
removed before you go home. The
instruments used for the
brachytherapy are put into place by
the radiation doctor. The placement
is checked with ultrasound. When
an ultrasound is done, a cool gel is
put on your lower belly. This helps
the doctor see your inner body parts.
You will go either to the CT or
View-Ray scanner in our clinic or the
MR scanner in the Radiology clinic.
The CT, View-Ray or MR scans are
used to make sure the instruments
are in the right places. This helps
plan for your radiation treatment.
You will be asleep for the entire CT,
View-Ray or MR scan.
3. After the CT, View-Ray or MR
images are done, the radiation
treatment is planned. This is done by
the medical physicist. He or she uses
a prescription from the radiation
doctor. A computer software
program is used to plan the
treatment. It is checked and
approved by the radiation doctor.
4. The radiation that is used comes
from a tiny piece of radioactive
matter. This is about the size of a
piece of pencil lead. It is attached to
a wire and kept inside a lead-lined
5. The radiation doctor connects one
end of the thin hollow cables to the
storage box. The other ends of the
cables are attached to the ends of the
brachytherapy instruments. During
the treatment, the radioactive matter
moves out of the storage box and
into the brachytherapy instruments.
It stays there until the prescribed
dose of radiation is given (about 5 –
6. After the radiation dose has been
given, the radioactive matter returns
to the storage box. It does not
remain in your body. The treatment
part of the procedure is now over.
All of the instruments are removed.
Your legs are lowered back onto the
table. You are “brought out of” the
anesthesia. You are moved to the
post-anesthesia care unit and
checked for about an hour. After you
are more awake, you are moved to
the discharge unit. This total
recovery period can last from 2-3
7. Once you are fully awake, you will
be given something drink. Family
members or friends can visit. You
will be prepared for discharge. The
radiation doctor may wish to talk to
you and answer any questions you
may have. You may remember bits
and pieces of the procedure, or you
may remember nothing at all.
Because of the medicine given for
anesthesia, you should not drive,
drink alcohol, use dangerous
equipment, or make any major
decisions for 24 hours.
What can I expect after Brachytherapy?
1. You may have some minor vaginal
bleeding or discharge for the first 24
hours. It should not be more than a
normal menstrual period. We can
provide you with a sanitary pad or you
can bring one from home; DO NOT
2. Please do not douche during the time
you are getting treatments. Douching
can disrupt the body’s natural chemical
3. You may have some vaginal cramping
(similar to menstrual cramps) after the
procedure. This should stop by the end
of the day. Ibuprofen (Advil® or
Motrin® IB) or naproxen (Naprosyn®
or Aleve®) may help. Take it
according to the directions on the
4. You may have some irritation or
burning when you urinate. This can be
related to the catheter that was put in.
You should drink 8-12 glasses of
fluids each day for the next 1-2 days.
Let us know if these symptoms do not
5. Your memory of the treatment may be
fuzzy. This is a short-term side effect
of the anesthesia medicines.
6. After your treatment, you may resume
your normal diet.
7. You are not radioactive after this
8. You will be given a vaginal dilator or
vibrator at one of your visits. How it is
used will be explained to you. You
will need to use it because the
brachytherapy treatments cause the
vagina to narrow and shorten. Your
health care team will tell you how long
you will need to use it.
9. It is safe to have sex between treatments.
10. Call the Radiotherapy doctor at
(608) 263-8500 for any of these
Fever above 100ºF.
Pain that is not relieved with
Bleeding more than a normal
Burning with urination or
blood in the urine lasting more
than 24 hours.
Your radiation doctor is _____________________________ Phone Number ________________
Or call______________________at___________for any questions or concerns.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4392.