Frequently Asked Questions

ProstRcision: Treatment Effects

Q: What is the most common problem men experience after ProstRcision?

A: The most common side effect seen after ProstRcision is a weak urinary stream with more frequent urination and more urgency. These symptoms vary from man to man and are primarily related to the size of a man’s prostate and the amount of urinary symptoms he has prior to the seed implant. Men who have a weak stream after ProstRcision typically find their symptoms gradually resolve over 6-12 months as the prostate shrinks and the normal and cancerous prostate cells disintegrate.

Q: What causes a weak stream?

A: The cause of the weak stream is from trauma to the prostate due to the insertion of the 8-inch long needles into the prostate gland through which the seeds are injected. Insertion of these needles causes sudden prostate swelling, which leads to compression (squeezing) of the urethra tube that empties the bladder and runs through the middle of the prostate.

Q: Can you do anything for the urethral compression?

A: Yes. Men who have a significantly slow stream are offered medication called alpha blockers such as Flomax® (tamsulosin), Uroxatral®, Cardura® or Hytrin®. This medication relaxes muscles inside the prostate irritated by the sudden swelling and, in turn, relieves pressure on the urethra, which results in better urination in most men.

Q: Can men develop urinary blockage after the seed implant of ProstRcision?

A: Yes. Overall, 2.6% of men will have enough swelling after the implant that they have blockage of the urethra and require insertion of a urinary catheter. The average time to wear a urinary catheter in the men who have urethral blockage is six days.

Q: I understand men may develop urinary leakage and need diapers after Radical Prostatectomy. Do men develop urinary leakage (incontinence) after ProstRcision?

A: We monitor this but rarely see incontinence after ProstRcision. We are not cutting out any of the urinary muscles. However, men who have had a prior TURP (roto-rooter operation) or have severe urinary urgency before the seed implant of ProstRcision may develop incontinence.

Q: Do men have rectal problems after ProstRcision?

A: The most common symptoms we see are more frequent bowel movements per day, for example, from 1 to 2. This can last for one to two months and then resolves. These bowel symptoms are due to irradiating around the prostate for microscopic capsule penetration. If a man has hemorrhoids, he may see spotting of blood, especially after a hard bowel movement. Stool softeners usually resolve this problem.

Q: What is the worst complication that can occur after ProstRcision?

A: The worst complication is a rectal fistula. A fistula means development of a hole between the rectum and the urethra so that urine passes through the rectum. This is a serious condition that requires a colostomy bag and surgical repair. A fistula is rare after ProstRcision. Of the last 10,000 men treated, only one has had a fistula.

Q: If you destroy all the normal prostate cells, does this harm sexual function?

A: Not necessarily. You can still get an erection and have a normal orgasm. Prostate cells make semen, so no semen is produced.

Q: What is the chance of keeping sexual function after ProstRcision?

A: There are two main factors that determine preservation of sexual function after ProstRcision: a man’s age and the quality of penile erection before treatment. For example, men with normal erection and age 50 or younger have a 94% chance of retaining sexual function, as compared to men age 76 or older with normal erection function, who have a 40% chance of keeping sexual function. If men do have problems with erection, they can use Viagra® or Cialis®. Your chance of keeping sexual function is 72% calculated from our database.

Q: With the seeds in my prostate, can I be around other people?

A: Yes, you are not a risk to anyone. You can be around anyone and can sleep in the same bed with your wife. However, to be on the safe side, we recommend that you keep two feet distance from young children and pregnant ladies (except for a brief daily hug) for two months after the implant.

Q: I have heard that radiation can cause cancer. Is there an increase in cancer, especially bladder or rectal cancer, after ProstRcision?

A: No. The chance of men who have received ProstRcision developing other cancers is no different than what we see in the general population of men who have never been treated for prostate cancer.

Q: What happens with most men after ProstRcision?

A: ProstRcision has very little effect on most men. The day after the implant, men can travel, work, go to the gym or play golf. Except for Tylenol, pain medication is rarely needed. Urinary leakage rarely occurs, and most men who are sexually active retain sexual function. Some men report a mild degree of fatigue for a few months after treatment. On a long-term basis, a few men will develop a temporary increase in urinary symptoms consisting of burning with urination and urinary urgency 18 months after the implant. These symptoms usually resolve within a short time. Problems from ProstRcision are uncommonly seen after 24 months.

Q: Would I be a good candidate for ProstRcision?

A: Yes. Your chance of a zero PSA at 15 years is 85%, and calculated from our database, your chance of urinary incontinence is less than 1% and your chance of keeping sexual function is 72%.