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Brachytherapy (also known as interstitial radiation therapy or seed implant therapy) works along the same lines as conventional radiotherapy except it is an internal, rather than an external, treatment. During the procedure a number of small metal pellets are inserted into the prostate and these emit radiation into the gland over the course of the next year. The pellets are permanent once inserted but they are too small for the patient to be aware of their presence.

Prior to treatment the patient is given a TRUS to ensure that the prostate is not too large and, therefore, determine eligibility for the procedure. The brachytherapy is a minor surgical procedure and patients are normally admitted as day cases. A TRUS is inserted into the rectum and this guides the urologist, who inserts a number of tiny hollow needles through the perineum and into the prostate. The needles deposit the radioactive seeds at previously mapped situations throughout the whole of the prostate to ensure maximum effect. When the procedure is over the patient will be catheterized and this will normally remain in place until the following day.

After the seed implant it is important to abstain from sexual intercourse for approximately two weeks. After this a condom should be used for a limited amount of time as advised by the urologist. In the short term it is also advisable to avoid close contact with pregnant women or children for more than fifteen minutes a day.

The side effects of brachytherapy include increased frequency in urination, a burning sensation with urination or ejaculation, rectal discharge or mucus and some blood in the urine or ejaculate. As with conventional radiotherapy these symptoms may not appear for the first two weeks after exposure to the radiation but they should subside within a few months of the treatment ending.