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Brachytherapy anaesthesia

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User
Posted 02 Aug 2022 at 15:48

I has a shot at HIFU last December but unfortunately the 6 months on the PSA is around 6.5 and the MpMRI showed a lesion that had no positive cores on two separate biopsies is now showing signs so awaiting the biopsy result but I clearly have multifocal disease albeit intermediate risk Gleason 3+4 and both sides. 

it may be that the biopsy show a need to move on from HIFU or be offered a 2nd shot- not sure yet but my question is about brachytherapy and High dose or seeds - what is the anaesthetic duration given my prostate is average size at around 30 - of course I never had any symptoms and with not a particularly large prostate at 71 - I feel and expressed my belief that the PSA is largely from ca and not BPH or inflammation- so PSA is more relevant at lower levels relative to my prostate size.

anyway I had hoped the the HIFU would have bought me a few years before readdressing it - nit my luck - so what are others experience and the anaesthetic time is quite important for me as l have other issues - 

User
Posted 02 Aug 2022 at 15:48

I has a shot at HIFU last December but unfortunately the 6 months on the PSA is around 6.5 and the MpMRI showed a lesion that had no positive cores on two separate biopsies is now showing signs so awaiting the biopsy result but I clearly have multifocal disease albeit intermediate risk Gleason 3+4 and both sides. 

it may be that the biopsy show a need to move on from HIFU or be offered a 2nd shot- not sure yet but my question is about brachytherapy and High dose or seeds - what is the anaesthetic duration given my prostate is average size at around 30 - of course I never had any symptoms and with not a particularly large prostate at 71 - I feel and expressed my belief that the PSA is largely from ca and not BPH or inflammation- so PSA is more relevant at lower levels relative to my prostate size.

anyway I had hoped the the HIFU would have bought me a few years before readdressing it - nit my luck - so what are others experience and the anaesthetic time is quite important for me as l have other issues - 

User
Posted 02 Aug 2022 at 20:41

When I had my HDR done, the GA was under an hour, and covered just the brachytherapy catheters (needles) insertion. Place where I was done then had you awake through rest of the procedure, which was fine - I was quite interested to see it all. Some other places knocked you out for the whole procedure, but the longer GA rules out some patients who would be OK for a shorter one.

However, when COVID came, my place switched to using spinal blocks instead, and they'll now only do GA in exceptional circumstances.

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User
Posted 02 Aug 2022 at 17:55

I had hdr brachy. I think they knocked me out, at 10am and I came around again at 1pm. So about three hours. I do not know if they have different levels of anesthesia. I would guess that they need less anesthesia for a relatively minor procedure compared to surgery, but this is only a guess.

Dave

User
Posted 02 Aug 2022 at 18:10

Originally Posted by: Online Community Member

 the anaesthetic time is quite important for me as l have other issues - 

You could ask about spinal block?

Cheers

Bill

User
Posted 02 Aug 2022 at 18:34

Thanks Dave, yes I guess it varies in size of prostate too as well as individual cases. When you say ‘came round’ that means your were conscious but of course that isn’t the length of time intubated and under the GA. How were you in the next month or so ? 

User
Posted 02 Aug 2022 at 18:36

Yes I know but some urologists are keen on GA as it helps to keep patient totally still and spinal isn’t so good for that - apparently - but I note it’s something that does seem to be used quite often 

User
Posted 02 Aug 2022 at 19:47

I don't know how long I was intubated. All I know is when I was conscious. By 4pm I was feeling reasonably normal. After an overnight stay I had my catheter removed, but I couldn't piss well so they sent me home with a catheter, after a week I could piss ok, and then I had 15 sessions of EBRT over the next three weeks.

Dave

User
Posted 02 Aug 2022 at 20:41

When I had my HDR done, the GA was under an hour, and covered just the brachytherapy catheters (needles) insertion. Place where I was done then had you awake through rest of the procedure, which was fine - I was quite interested to see it all. Some other places knocked you out for the whole procedure, but the longer GA rules out some patients who would be OK for a shorter one.

However, when COVID came, my place switched to using spinal blocks instead, and they'll now only do GA in exceptional circumstances.

User
Posted 03 Aug 2022 at 12:27

Hi 

I had low dose seeds and it seemed  to be done very quickly,I was pushed down to the operation theatre at about 2.oclock and was back in the ward by 4.oclock and that includes the time in the recovery room.

I was given a couple of pain killers and antibiotics but i had more discomfort than any pain and was ready for dinner.

Overall a brilliant team from start to finish and they said i could go home as soon as i could pass water into bottles they left on my window sill and had to be checked with a geigercounter for lost seeds that sat alongside the bottles.

By the time i left the next morning i had 16 bottles in a line ( and i have photos of them) so was able to go home the following day. I found the female nurses stayed away from me after the operation apart from a lovely night  sister that made me a cup of tea at 4.oclock as i was gasping by then.

 

regards John.

 
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