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How to prepare for your Prostate Seed Implant (PSI) (5731)

How to prepare for your Prostate Seed Implant (PSI) (5731) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cancer, BMT, Hematology


How to Prepare for Your Prostate Seed Implant (PSI)

A person having a PSI takes part in a 3-
phase process. The first phase of the
process is called the PSI Work-Up. This
phase makes sure that a PSI is right for you.
If a PSI is right for you, you begin the
second phase of the process. The second
phase of the process lasts 1 to 3 weeks and is
explained in this handout. This handout will
tell you how to prepare for the day of your

Preparing for your PSI requires that you
complete 4 tasks.

1. You will need to arrange for your
transportation home after your
2. You may need to make changes to
the medicines you take on a daily
3. You will need to complete a bowel
prep. This bowel prep begins the
day before your implant.
4. You will need to get to the hospital
at the right time. These tasks are
explained more fully below.

Task 1: Arrange Transportation
Home after your PSI

You will need to arrange for a friend or
family member to drive you home after your
implant. This is because patients getting
anesthesia are not allowed to drive home.
You should not drive or make important
decisions until the next day. This is for the
safety of yourself and others.

Task 2: Make changes to the
medicines you take on a daily basis.

You will need to make some changes to the
medicines that you take on a daily basis.
These changes are made both before and
after the implant.

Before your implant:

If you take blood thinning medicines, you
will need to stop taking them. You should
stop them 5-6 days before the implant. You
can resume taking these medicines 3-4 days
after the implant. The nurse will give you
more specific instructions about this.

You will need to start taking a medicine
called tamsulosin hydrochloride. You will
start taking it several days before the
implant. The doctor will give you a
prescription. This medicine will help you to
pass urine after your implant. It works by
relaxing the muscles in the neck of your
bladder. You should take at bedtime. It can
lower your blood pressure. It can also react
with other blood pressure medicine. You
should get up slowly when first taking this
medicine as it can cause dizziness if you get
up too quickly. The nurse will talk to you
about this. Let us know if you have
dizziness when taking the dose prescribed
by your doctor. He or she may wish to
lower the dose.

After your Implant:

You will be given a prescription for an
antibiotic. It will help to prevent an
infection. Call the radiation doctor if you
develop a rash or any other problem with
this medicine.

Continue to take tamsulosin every evening
at bedtime. Take it until you see the
radiation doctor at your first follow up
appointment. It will help you to pass urine.
You may take Tylenol for discomfort. You
may take 1-2 tablets (325mg) every 6 hours.
Take these tablets with food or milk if you
tend to get a stomach upset.

If passing urine is painful, you may take
Pyridium® (phenazopyridine
hydrochloride). The doctor will give you a

prescription for this medicine. Take one
tablet (200mg) three times a day. This
medicine helps to lessen the pain that can
occur with the passage of urine. It turns all
body fluids orange.

If you take blood thinning medicines, you
can resume taking them 3-4 days after the

Ask the nurse about this if you have any

Task 3: Complete your Bowel Prep

You will need to prepare for your implant by completing a bowel prep. Your rectum needs to be
clear of stool on the day of the implant. The bowel prep begins on the day before your implant.

Your implant is scheduled for _____________________________________________.

You may follow your normal diet until 12 noon on _____________________.

At 12 noon on ________________________you must begin a clear liquid diet. You must stop
eating all solid foods and dairy products. You must stop drinking any liquids that contain pulp or

Clear liquids include the following:

• Clear broth
• Consommé
• Tea
• Coffee, decaffeinated coffee
• Carbonated beverages
• Jell-O
• Hard candy
• Clear fruit juices (cranberry, grape, apple,
• Popsicles
• Fruitades or ices made from the allowed

You may eat and drink as much of the above as you would like.

DO NOT EAT ANYTHING AFTER MIDNIGHT on ____________________________.

On the evening before your implant, you must give yourself a Fleets® phosphate enema. This is
an over-the-counter product. It can be bought at any pharmacy. The next morning give yourself
another Fleets® phosphate enema. If you have been told to take your morning medicines, you
should take them with only a sip or two of water.

Task 4: Get to the Hospital at the
Right Time

Your Prostate Seed Implant has been
scheduled for the following date and time:


You should plan to arrive at least one hour
before the start time of your implant. .Allow
extra time for traffic, parking, and getting
checked in. Once you get to the hospital
you will need to follow the steps listed

 Park in the parking ramp.
 Come in through the Hospital or
Clinic entrance.
 Get your parking stub stamped in the
“Town Square” area.
 Stop and check in at one of the
Registration Desks.
 Go to the pre-procedure area:
In the pre-procedure area, you will be
assigned to a room. In this room you will
change into a hospital gown. A name band
will be put on your wrist. The nurse will
check you in. After this is done, a hospital
escort person will bring you down to the
procedure area on a cart. The implant is
done in the radiation department.

Before starting the implant, the anesthesia
doctor will talk with you. He or she will
review your records and ask you questions.
An intravenous (IV) line will be put into
your hand or arm. You will be asked to
walk into the procedure area and to lie down
on the procedure table. A blood pressure
cuff will be put on your arm. Sticky patches
will be put on your skin to monitor your
heart rate. Compression stockings will be
put on to keep the blood in your legs

The anesthesia doctor will give you
medicines through the IV. These medicines
will make you feel relaxed and sleepy.
Once you are fully asleep, a breathing tube
will be put into your throat. Your legs will
be placed in stirrups. Your scrotum will be
moved up out of the way.

The radiation doctor will clean the skin
between your scrotum and anus with
antiseptic soap. He or she will then insert a
probe into your rectum. This probe will
help the doctor to “see” your prostate gland.
Hollow, stainless steel needles will be put
into the tissue between your scrotum and
anus. The ends of these needles will go into
the prostate gland. Prostate seeds will then
be threaded up through the needles and put
into place. Placing all the seeds takes
between 60-90 minutes. The number of
seeds used depends on the size of your
prostate gland.

After the seeds are all placed, your skin will
be cleaned once more. Your legs will be

taken down from the stirrups and put back
down on the table. The anesthesia doctors
will wake you up. You will be moved to a
cart. A cold pack will be put on the skin
between your scrotum and anus. You will
be taken to the Post Anesthesia Care Unit
(PACU). In the PACU your blood pressure
and heart rate will be monitored. When you
are more awake, you will be returned to the
pre-procedure area.

After the PSI procedure

You will be given something to eat and
drink. Your family will be allowed to visit.
You will get an information card for your
wallet. This card will show the date of your
implant. It will also show that you have
radioactive seeds in your body. When you
are fully awake, have had something to eat
and drink, and are able to easily urinate you
will be ready for discharge.

Before you leave the hospital you will return
to the Radiation Department. A post
implant CT scan will be done. This scan
will check the placement of the seeds. The
doctor and nurse will give you final
instructions about what to do at home. A
friend or family member must drive you

At home you should take it easy for a few
days. Please see HFFY # 6568, What to
Expect after a Prostate Seed Implant.

Follow-up Appointment

You will see the radiation doctor about one month after your implant. The nurse will help you to
set this up. Your bowel and bladder function will be asked about. You will be asked about the
medicines you are taking. This follow up appointment can be set up when your implant is

Please call if you have any questions or concerns. The number for the Radiation Oncology
Clinic is (608) 263-8500. If you live outside of the Madison area, call 1-800-323-8942. If the
clinic is closed, your call will be transferred to our answering service. Ask to speak to the
radiation doctor on call. The doctor will call you back.

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 ©8/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5731.