Dad elected to have brachytherapy, had 71 seeds of I-125 placed April
22. Since then he has had significant pain and discomfort, and urinary
difficulties- both retention and dribbling. .  He also complains of
burning in his penis.

Dad is getting quite depressed, especially as the doctors, who did not
prepare him for extended urinal problems, are not forthcoming with any
information on how long this will last, or even whether it will end.

Wearing a catheter permanently is very difficult for my dad.

I also wonder whether the catheter is a good idea to wear for a long
time,
Does the catheter cause burning in the penis? After the retention
experiences which were quite traumatic, dad doesn't know whether it is
better to just keep the catheter for a while (how long?) or try to
remove it periodically.

--Lisa
==================
hi lisa - since you posted and nobody has said anything, i'll chime in.  

first and foremost, you have to understand there are no hard set rules
when it comes to prostate cancer.  general guidelines at best.  

one person could have seeding done with no problems and the next person
could have all kinds.

i will try to answer some of your concerns.

again, let's address the issue at hand.  given his psa, gleason and
stage, he made a good choice.  the doctor and his staff should have
prepared him for what to expect and the possibility of complications and
what kind of complications he could have.  from what you are saying,
that didn't happen or very little did.

when you put seeds into the prostate, the gland is going to swell in
protest.  so, it's possible he could have urine retention problems and
hence the catheter.  burning in the penis, that can come from different
reasons and you didn't make yourself clear.  one of the reasons could be
the seeds is irritating a nerve inside and giving the feeling of that
sensation.  another reason could be as to which type of catheter he is
wearing.  if he is wearing the latex type, they appear to have more drag
and the tip of the penis gets sore easier.  the silicon model is
considered for long term use and doesn't give as much pain as the other
type.  i've had both types and i could definitely tell a difference
between the two types.  bladder control muscles may get a little weak
but once the catheter is out, that will straighten up.  

right now, it appears to be a swollen gland situation and it is just
going to take some time to get through this phase, but it shouldn't come
back once he's through it.

i hope this helps.

maybe some of the brachathrepy folks will chime in.

~ curtis

Well, guess your dad hit that little percentage of brachytherapy patients
who have urination problems that aren't so little. My husband had brachy too
and hit that <4%percentage who have urination problems. Here's what I know.

Brachytherapy does cause the prostate to swell. That swelling can put
pressure on the nerves. With my husband it put pressure on the nerves
controlling the valve that allows the bladder to "release" urine. So his
problem was getting started. It was drop to his knees sort of pain. And it
lasted for months.

Most men who experience this find that it only lasts a few weeks. So I would
think that maybe they would try to get your father off the cath as soon as
possible. I'm sure the complications have to do with the BP. The meds they
give for this problem would probably lower his BP too much so they are not
using them (Flomax or Hytrin and occasionally Proscar).

You might want to check if there is another stronger anti-inflammatory they
could give him. That might help with the swelling and get him back to normal
sooner. My hubby took a Rx strength Naprosyn.

Time will cure the problem. Have him talk to the doctor about getting rid of
the cath. Maybe he can keep on so he can cath himself if need be to pee but
see if he can't go without it. Long term use is not good - but I'm not sure
why.

Would your dad feel better about talking to my husband? Contact me by email
privately and he can call him one evening if you are in the USA or Canada.
My husband knows exactly what he is feeling except he never had them put a
cath in for it.
Bev

I had this problem after HDR brachytherapy - which is a different
type in which very high dose rate seeds are implanted for a very
short time (15 minutes) and withdrawn.  I thought I was going to
bust my bladder trying to urinate afterwards.

They gave me Flowmax and an injection of a steroid
anti-inflammatory to get me past the immediate problem.
From then on, Flowmax plus lots of ibuprofen kept it under
control.  I had problems for about 6 weeks, with the worst of
the problems lasting about 3 weeks and gradually getting
better.  After 6 weeks I was able to get off the Flowmax and
by about 8-10 weeks I was basically back to normal.

With long term seeds, the problem can last longer than mine
because the radiation is continuing to be administered over
a long period of time.

However, in spite of that, I suspect your father is in
the very worst part of it right now, and that it will start to
get better soon.  I have read that tissue reacts to radiation
by swelling (thus clamping down on the urethra and blocking
flow) but that, after a certain point, it adjusts to the radiation
and the swelling subsides.

Here's one possibility to discuss with the doctor:

1. Get the best anti-inflammatories available for him, consistent
with his high blood pressure and any other problems.

2. Get a self-catheter kit - a thin, silicon catheter that he
can insert himself, and get the doctor to show him how
to do it.

3. Remove the main catheter and see how it goes.  He
may be able to dribble enough out that he can get by
without actually catherizing himself.  But if things get bad,
he can do it himself without rushing to the emergency
room and waiting two hours for treatment.  It may
be possible for him to put it in, drain the bladder,
and take it out again, without having to leave it in
permanently.

One other thing: If he has burning in the penis it is
possible he's got a urinary tract infection caused by
the catheter, in which case an antibiotic might help
a great deal.  This is something to ask the doctor about.

Incidentally, I found it easier to urinate standing up
than sitting on the toilet.  It might also help to just stand
up for a while holding a urinal and getting little dribbles
with a bit of walk and dance inbetween to get things
moving again.

Best of luck.

   Alan

I ran into some guys on another PCa website who claimed that pumpkin
seeds and/or pumpkin seed oil relieved their post-seeding urinary
problems, so I started taking two 1000 mg. pumpkin seed oil capsules a
day and snacking on roasted pumpkin seeds about six weeks before my
implant (which took place two weeks ago).  I've continued that routine
since and haven't yet experienced any significant urinary
complications (some burning, a little weakening, but that's all...no
real urgency).  I wouldn't swear that the pumpkin seeds are the
reason, and I am still taking my prescribed dose of Flomax, but it
might be worth a try for your father.  You can get pumpkin seed oil
capsules at any GNC or vitamin store, and so far as I know, they don't
have any side effects (although my wife claims that my skin is
acquiring a bright orange glow and has begun calling me "Jack").