GYN Brachytherapy: Interstitial Implant
Date of Procedure: ____________________________
What is interstitial radiation?
Interstitial radiation is a way to give
radiation to a small area. This involves the
placement of needles directly into the tumor
site. This way less normal tissue is affected.
Your doctor can give a higher dose of
radiation in a shorter time than with external
This type of treatment is quite involved. You
may have an epidural catheter placed into
your back during the entire procedure. This
will allow us to give pain medicine directly
to your pelvis. The Anesthesia Screening
clinic staff will discuss this in more detail.
Patients that require an epidural or spinal
anesthesia may need a pre-surgical screening
ξ a physical exam by your radiation
ξ blood work
ξ chest x-ray
Your radiation oncology doctor may request
laparoscopic assistance to place the needles.
If so, you may also need to see a
gynecologic oncology doctor prior to your
The radiation procedure involves placing
instruments into the vagina. Usually this is a
small cylinder-like tube. Most commonly, a
small template with holes is slid over the
cylinder. It rests against the perineum (the
skin around the vagina). Small hollow
needles are inserted through the holes in the
template. These tubes go into the tumor site.
(See diagram on page 3). Other times the
needles are placed using a different type of
instrument in the vagina. They may also be
placed directly into the vagina without the
template. They are then sewn directly to the
skin of the perineum. These instruments will
be placed in the operating room (OR).
After the instruments are placed you may be
taken to Radiology or Radiation Oncology
for imaging. This imaging is used to help
create your treatment plan. You will then go
to the recovery room. After you are awake
you will be moved to your room. You may
be moved to the Radiation oncology clinic
for a CT scan to plan the radiation
treatments. When your radiation doctor has
all the information needed to start your
treatment plan, you will return to your
hospital room. Once the plan is finalized,
you will be brought to the Radiation
Oncology Clinic on your bed to start your
The radiation sources are inserted into the
small hollow needles. They will remain
there until the desired radiation dose is
delivered. This can take 10-25 minutes.
Treatment times vary. Usually the treatments
are given twice a day (morning and
afternoon). Your doctor or nurse will explain
your treatment plan to you. Once all of the
radiation treatments are done, the needles
and other instruments will be removed.
How to prepare your bowels:
1. 48 hours or 2 days before the implant:
Start a clear liquid diet. Clear liquids are
foods which are liquid at room
temperature. Examples of clear liquids
include: clear broth, consommé, tea,
coffee, decaf coffee, Jello®, carbonated
drinks, hard candy, clear fruit juices
(cranberry, grape, apple, cherry) and fruit
ades or ices made from allowed juices.
2. 24 hours or 1 day before the implant:
Drink 2 - 10 oz bottles of magnesium
citrate. You can buy these at any
drugstore. They do not require a
3. The evening before the implant: Give
yourself 1 Fleet’s® (phosphate) enema.
You can buy this at any drugstore. It
does not require a prescription.
4. Do not eat or drink anything after
If you have any questions or problems doing
the bowel prep, please call the Radiation
oncology Department at (608) 263-8500.
Day before Implant
The time of your implant will be set the
business day before the implant. A nurse
from the First Day Surgery (FDS) Center
will call you the business day before the
implant. They will tell you when to arrive,
where to go, and answer questions. If you
don’t hear from them by 3:00 pm, please
call (608) 265-8857. If you wish to stay in
Madison, a Housing Accommodations
Coordinator, (608) 263-0315 can provide
you with a list of nearby motels and arrange
for your stay at a discount rate.
Day of Implant
Please check in at the FDS Center located at
E5/3 at your scheduled time. Leave your
valuables such as jewelry and money at
home or with a family member. We ask that
your family bring your belongings to your
room after the procedure.
While you are in FDS, they will help you get
ready for your implant. You may have
family with you when you arrive. Due to
limited space, you will need to choose a
primary support person. This is the only
person who may stay with you from check-
in time until you go for your implant. When
choosing a primary support person, keep in
mind this person may hear your private
health information. There is a waiting room
for other family members and friends. After
the check-in process is complete, they are
welcome to see you in your FDS room for a
short 5 minute visit.
You will need to change into a gown. An
intravenous line (IV) will be started. The
staff will review your medicines, allergies,
and medical history. During this time you
will also meet the anesthesiologist.
The anesthesiologist may place an epidural
catheter in your back. This gives you pain
medicine to make you comfortable. This will
be removed when the radiation treatment is
over. They may also use a general
anesthesia. This means you would need to
have a breathing tube placed. The tube will
be removed before you leave the operating
Your radiation oncology doctors will be in
the OR to place the instruments. You may be
awake depending upon the type of
anesthesia chosen. Let us know if you feel
any pain. A catheter will be placed to drain
urine from your bladder. It will stay in until
the radiation treatment is done. The
radiation oncology doctors may request help
from a gynecology oncology doctor by using
laparoscopy to help guide the needles.
Below is a picture of the implant.
After the implant is placed you will be taken
from the OR to the recovery room. You may
then be taken to your room, the Radiation
oncology clinic for a CT or View Ray scan,
or radiology clinic for an MRI.
Your entire hospital stay may be 4-7 days.
This is based on your treatment plan. Due to
the position of the implant, your movement
will be limited. Your nurse will help you to
change positions. You will have a catheter in
your bladder. You will not be able to get up
to go to the bathroom. Compression
stockings will be placed on both legs. This is
to help blood flow and prevent blood clots
from forming. You will also get shots in
your stomach to help prevent blood clots. A
soft diet will be provided for you.
When the radiation treatment is completed,
the implant will be removed in the Radiation
Oncology Clinic. If you have an epidural
catheter, it will be removed in your room.
When you are able to get up and walk
without help, you will be discharged home.
Home Care Instructions
1. Some vaginal spotting or bleeding is
expected. This should stop within 1-2
days. You may bring a sanitary pad from
home. If not, we will give you one. Do
not use tampons.
2. Do not put anything into your vagina for
2 weeks unless instructed to do so by
your treatment physician. Douching can
disrupt the body’s natural chemical
3. A catheter will be placed in your bladder
while you are in the hospital. You may
have some irritation or burning after it is
removed. You should drink 8-12 glasses
of fluids each day for the next 1-2 days.
4. You may have some discomfort or
soreness around the vagina. We will give
you a prescription for pain medicine if
you need it.
5. Our experience shows women who use a
sitz bath often (4-6 times per day) feel
more comfortable and heal faster. You
can use your bathtub or we can give you
a sitz bath. To use the portable sitz bath,
place it on the toilet and fill it with
lukewarm water. You may add some
cornstarch if you wish, just enough so
the water turns white. Use this as often
as you need – but remember more often
6. You may be given a prescription for an
antibiotic. Follow the directions on the
bottle. Be sure to take the entire
7. You will be given a vaginal dilator to
use at your first follow-up visit. The
radiation may cause the vagina to
become narrow and tight. The dilator is
used daily to help maintain the vaginal
opening. You will receive instructions
8. It is safe to have sexual intercourse after
the implant. It may be uncomfortable for
9. You are not radioactive after the implant
10. Call the radiation oncology staff for any
of these symptoms:
Fever above 100º F.
Pain that is not relieved with
Bleeding more than a normal
Burning with urination or blood in
the urine lasting more than 24 hours.
Call the Radiation oncology Clinic at (608)
263-8500. If the clinic is closed, your call
will be transferred to the answering service.
They will put you in contact with the doctor
Your doctor is:
If you have more questions or concerns
regarding this procedure, you may also
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 © 8/2017. University of Wisconsin Hospitals and
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5329