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Needles are placed accurately to the target point through the guidance template under transrectal ultrasound imaging. Seeds are then injected through the needles without any incisions making this a minimally invasive procedure.

Permanent Seed Brachytherapy

Surgery and XRT have similar 10 yr survival
(JAMA Consensus 1987)
5 year PSA results equivalent to surgery and external beam radiation
(American Brachytherapy Society/GEC European Society for Therapeutic Radiation Oncology May 2000)
Continency rate higher than surgery
Potency rate higher than surgery or external radiation
24-48 hour recovery time
Outpatient procedure
Less patient discomfort than surgery
Cost competitive

Seed Patient Selection Guidelines

Greater than 10 year expected longevity
Gland confined cancer
Less than 60 cubic centimeter gland preferred, but not essential
Trans urethral resection of the prostate for benign enlargement (“rotor rooter”) is not a contraindication to seeding. Chance for urine leakage after seeding with intraoperative treatment planning is less than 1%.
No evidence that younger age patients do better with surgery although many surgeons claim this without any scientific basis.
Men in their 40's and 50's are excellent seed candidates
Every radical prostatectomy candidate is a candidate for permanent seeding

Current Studies Documenting the Effectiveness of Prostate Brachytherapy from Merrick, et. al., J Urol. Vol. 169 1643-1652, May 2003

Complications of seed therapy are less than for surgery or external beam radiation
Herr, CA Vol47 no4 1997

Physician Reported Complications post Radical Prostatectomy
Stanford JL, JAMA 2000 (SEER Registry Data)
Walsh PC Urology 2000

Patient Reported Complications Post Radical Prostatectomy Increase as Time Goes On
Stanford JL, JAMA 2000 (SEER Registry Data)

Seeds vs Radical Prostatectomy; Range of Reported Incontinence
Middleton RG, J Urol 95; Sylvester J, J Surg Onc 97; Beyer DC, Int J Rad Onc Bio Phy 97; Ragde H, Sem Surg Onc 97; Zelefsky M, J Clin Onc 99; Arterbery V Sem Surg Onc 97

Seeds vs Radical Prostatectomy; Range of Reported Impotence
Middleton RG, J Urol 95; Sylvester J, J Surg Onc 97; Beyer DC, Int J Rad Onc Bio Phy 97; Ragde H, Sem Surg Onc 97; Zelefsky M, J Clin Onc 99; Arterbery V Sem Surg Onc 97

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